Clinical Aspect and Treatment of Intracranial Mycotic Aneurysm

Won Sup Oh

doi:10.3947/ic.2010.42.6.369

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Oh: Clinical Aspect and Treatment of Intracranial Mycotic Aneurysm

Review Article

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(6): 369-374.

Published online: 31 December 2010

DOI: https://doi.org/10.3947/ic.2010.42.6.369

Clinical Aspect and Treatment of Intracranial Mycotic Aneurysm

Won Sup Oh

Department of Internal Medicine, Kangwon National University College of Medicine, Chuncheon, Korea.

Correspondence to Won Sup Oh, M.D., Ph.D. Division of Infectious Diseases, Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, 26 Kanwondaehakgil, Chuncheon, Kangwon-do 200-947, Korea. Tel: +82-33-258-9466, Fax: +82-33-258-9471, wsoh@ymail.com

Received 2 December 2010 Accepted 4 December 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Intracranial mycotic aneurysm (IMA) is rare, but life-threatening cerebrovascular lesion, which arises from a variety of primary infection foci such as infective endocarditis, bacterial meningitis, cavernous sinus thrombophlebitis, etc. The diagnosis of IMA usually depends on the documentation of an intracranial aneurysm by vascular imaging in the presence of primary infection foci. As the gold standard for detecting IMA, high-tech computed tomography will eventually replace cerebral angiography. Because of the lack of prospective cohorts and randomized controlled trials, there is no widely accepted treatment guideline for IMA. With recent advances in surgical technique and the introduction of endovascular therapy, however, clinical outcome of patients with IMA tends to improve. This review will provide the state-of-the-art knowledge on clinical aspect and treatment strategy of IMA.

Keywords: Intracranial mycotic aneurysm, Infective endocarditis, Endovascular therapy

Figures and Tables

Figure 1

Pathogenesis of intracranial mycotic aneurysm.

Figure 2

Algorithm for management of patients with intracranial mycotic aneurysm.

Figure 3

Endovascular therapy (EVT) for intracranial mycotic aneurysm.

(A) Pre-EVT state. (B) Post-EVT state.

Table 1

Sources of Primary Infection

Table 2

Review of Case Series of Intracranial Mycotic Aneurysm

Table 3

Diagnostic Criteria of Intracranial Mycotic Aneurysm [24]

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