Document Detail


Endovascular treatment of intracerebral mycotic aneurysm before surgical treatment of infective endocarditis.
MedLine Citation:
PMID:  15212129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Mycotic aneurysms are rarely seen in patients who have infective endocarditis, and the management of these patients remains controversial. We present the case of a patient who had infective endocarditis complicated by a mycotic aneurysm of the left middle cerebral artery. There was substantial mitral regurgitation, and Streptococcus viridans was isolated from the blood samples. Dysarthria appeared during the 4th week of the antibiotic therapy, but resolved completely 8 hours after onset. The left middle cerebral artery was embolized with platinum detachable coils. On the 7th day after the radiologic intervention, the native mitral valve was replaced with a 33-mm St. Jude Medical bi-leaflet mechanical mitral prosthesis. Most mycotic aneurysms show notable regression of symptoms with effective antibiotic treatment, and a very few may diminish in size. However it is impossible to predict the response of these aneurysms to therapy. To prevent the perioperative rupture of mycotic aneurysms and intracranial hemorrhage, priority should be given to endovascular interventions to treat cerebrovascular aneurysms in patients such as ours.
Authors:
Hasan Basri Erdogan; Vedat Erentug; Nilgun Bozbuga; Deniz Goksedef; Esat Akinci; Cevat Yakut
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  31     ISSN:  0730-2347     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2004  
Date Detail:
Created Date:  2004-06-23     Completed Date:  2004-10-18     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  165-7     Citation Subset:  IM    
Affiliation:
Department of Cardiovascular Surgery, Kosuyolu Heart and Research Hospital, 81020 Kadikoy, Istanbul, Turkey. gulayhasan@superonline.com
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / therapeutic use
Cerebral Arteries / pathology
Embolization, Therapeutic* / instrumentation
Endocarditis, Bacterial / complications,  surgery*
Humans
Intracranial Aneurysm / complications,  therapy*
Male
Middle Aged
Mitral Valve / microbiology
Rupture / prevention & control
Viridans Streptococci / isolation & purification
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents
Comments/Corrections

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