title: Middle cerebral artery aneurysm due to Nocardia asteroides: case report of aneurysm excision and extracranial-intracranial bypass.
abstract: Nocardia asteroides is an uncommon human pathogen typically encountered in immunocompromised patients. Primary central nervous system (CNS) nocardiosis is rare and usually manifests as cerebritis or abscesses. The case of a young woman who presented with CNS Nocardia abscesses complicated by an infective middle cerebral artery aneurysm is reported. Treatment, which included abscess aspiration, aneurysm excision, and end-to-end extracranial to intracranial bypass and prolonged antibiotic therapy, resulted in an excellent outcome. This case and the management of CNS nocardiosis are reviewed.
authors.affiliation: Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona.
authors.forename: M N
authors.initials: MN
authors.lastname: Hadley
authors.forename: R F
authors.initials: RF
authors.lastname: Spetzler
authors.forename: N A
authors.initials: NA
authors.lastname: Martin
authors.forename: P C
authors.initials: PC
authors.lastname: Johnson
mesh_terms: D000328:Adult; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D002548:Cerebral Revascularization; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery; D009617:Nocardia Infections / Q000150:complications*; D009616:Nocardia asteroides; D011859:Radiography