[Mycotic aneurysm in endocarditis lenta as the etiology of intraparenchymatous cerebral hemorrhage].
METHODS
A 49-year-old male was admitted for left-side headache and mild speech defect. Clinical examination showed a pansystolic murmur of mitral regurgitation and mild Wernicke aphasia. In laboratory studies ESR and CRP were increased. Computed tomography of brain revealed a left temporoparietal hematoma. Echocardiographic examination demonstrated vegetations and mitral valve perforation. In blood cultures grew alpha-streptococci. Cerebral angiography was performed and a fusiform aneurysm on a distal branch of the left middle cerebral artery was identified. Follow-up angiography showed a total resolution of the aneurysm after 6 weeks of intravenous antibiotics.


CONCLUSIONS
This case demonstrate that patients with intracerebral hematomas associated with infectious endocarditis should be investigated for mycotic intracranial aneurysm.
Würker
M
M
Klinik und Poliklinik für Neurologie und Psychiatrie, Universität Köln.
Szelies
B
B
Heindel
W
W
Böhm
M
M
Fischbach
R
R
Heiss
W D
WD
D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology*; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D003952:Diagnostic Imaging; D004698:Endocarditis, Subacute Bacterial / Q000150:complications* / Q000175:diagnosis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000175:diagnosis; D013290:Streptococcal Infections / Q000175:diagnosis / Q000209:etiology*; D013298:Streptococcus sanguis
Mykotisches Aneurysma bei Endocarditis lenta als Ursache für intraparenchymatöse Hirnblutung.