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Journal of Korean Neurosurgical Society 2001;30(1): 73-77.
Two Cases of Surgical and Medical Treatment of Infectious Intracranial Aneurysms: Case Report.
Sung Soo Ban, Chi Sung Ahn, Myung Hun Jung, Il Seung Choe, Sun Wook Choi, Kwan Young Song, Dong Soo Kang
Department of Neurosurgery, Kangnam General Hospital, Public Corporation, Seoul, Korea.
ABSTRACT
OBJECT: To determine whether to use surgical or medical therapy in treatment of infectious intracranial aneurysms, we reviewed two recent cases of infectious intracranial aneurysms and others known previous reports of aforementioned cases. Hence, we attempted to compare the validity and effectiveness of surgical and medical treatment.
METHOD
Recently, we treated two cases of ruptured infectious intracranial aneurysms. In former case, the aneurysm was located distal to the middle cerebral artery in a patient with mild mitral regurgitation of the heart. In latter case, the aneurysm was multiple with varying hemorrhage. The hemorrhage was located bilaterally and a moderate mitral regurgitation and infective endocarditis were accompanied in this patient.
RESULT
Due to the large size of the intracranial hematoma, stable medical condition, and easy resectability, we treated the former patient surgically. And, because of successive hemorrhage by multiple aneurysmal rupture, and the risk of heart failure, we treated the latter patient medically with serial follow-up angiography. Both patients are at present in good health.
CONCLUSION
Because of the variability in associated factors, such as the patient's health, the number of lesions, location, anatomy of the aneurysms and the causative organism, each patient's care must be individualized and tailored to the patient's particular clinical situation.
Key Words: Infectious intracranial aneurysm; Infective endocarditis; Surgical treatment; Medical treatment
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