Mycotic aneurysm of the posterior cerebral artery

Case contributed by RMH Report Writing

Presentation

Known bacterial endocarditis, now presenting with headaches.

Patient Data

Age: 43-year-old
Gender: Male
DSA (angiography)

Cerebral angiogram (DSA)

Angiogram via left vertebral artery injection again demonstrated irregular fusiform aneurysmal dilatation of the P2 segment of the right posterior cerebral artery associated with multiple saccular aneurysms arising from its superior and inferior divisions. These have increased in size and number compared to the DSA performed on 5/11/15, with the largest measuring 3.7 x 3.6 mm. Via a Scepter 4 x 10 mm catheter with its tip positioned in the right P2 just proximal to its bifurcation,

Case Discussion

Intracerebral mycotic aneurysms are uncommon. They are now most commonly seen in patients with a history of drug abuse and secondary endocarditis.

They are more common in the anterior and middle  cerebral artery territories.

They are often more peripheral in location than berry aneurysms.

Rupture with subarachnoid or intracerebral bleed is the feared complication.

PlayAdd to Share

Case information

rID: 40973
Case created: 10th Nov 2015
Last edited: 13th Nov 2016
Tag: rmh
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.