Presentation
Headache, recent prosthetic aortic valve endocarditis (Streptococcus sanguinis)
Patient Data
Age: 65 years
Gender: Male
From the case:
Mycotic aneurysm
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/107417/annotated_viewer_json?lang=us"}
Subarachnoid hemorrhage in the left Sylvian fissure.
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/107415/annotated_viewer_json?lang=us"}
- New left temporal intraparenchymal hematoma with surrounding edema
- Increased subarachnoid hemorrhage in the basal cisterns and sulci of the left cerebral hemisphere
- Suspected 8 mm left middle cerebral artery M2 aneurysm, anterior to the intraparenchymal hematoma
From the case:
Mycotic aneurysm
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/107418/annotated_viewer_json?lang=us"}
6 mm left middle cerebral artery M2 bifurcation aneurysm with active extravasation
Case Discussion
A ruptured distal/peripheral cerebral aneurysm in a patient with recent history of left-sided infective endocarditis is consistent with a mycotic aneurysm. A peripheral location is highly uncommon for non-mycotic berry aneurysms. This patient was treated endovascularly with coil embolization, so pathologic proof of mycotic aneurysm was not obtained.
Unable to process the form. Check for errors and try again.