[Cerebral hemorrhage due to a ruptured mycotic aneurysm. Two cases].
BACKGROUND
Cerebral hemorrhages due to rupture of mycotic aneurysms are rare but severe complications of infective endocarditis. We report two cases with a good outcome.


METHODS
The first patient presented with a parieto-occipital hematoma which occurred in the course of a relapsing infective endocarditis due to Streptococcus mitis. She fully recovered after neurosurgical treatment. In the second case, a right frontal hematoma revealed two mycotic aneurysms and an infective endocarditis due to Streptococcus gordonii. Motor weakness partially recovered after antibiotic therapy and angiography demonstrated complete resolution of aneurysms.


CONCLUSIONS
Ruptured mycotic aneurysms are poor prognosis factors in infective endocarditis. Adapted antibiotic therapy is the first-intent treatment. Neurosurgery is indicated when hematomas are poorly tolerated and in cases requiring anticoagulant therapy.
le Bayon
A
A
Service de neurologie A, centre Gui-de-Chauliac, 80, avenue Fliche, 34295 Montpellier, France.
Lebourg
O
O
Blard
J M
JM
Pagès
M
M
D000328:Adult; D017542:Aneurysm, Ruptured / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000175:diagnosis*; D005260:Female; D006801:Humans; D019635:Neurosurgical Procedures; D011379:Prognosis; D013290:Streptococcal Infections / Q000175:diagnosis*
Hémorragie cérébrale par rupture d'anévrisme mycotique. Deux observations.