Staphylococcus endocarditis associated with infectious vasculitis and recurrent cerebral hemorrhages.
BACKGROUND
Patients with infectious endocarditis, who do not respond to conservative medical therapy usually need rapid valve surgery. This poses a difficult dilemma in patients with intracranial aneurysms and hemorrhage, although endovascular treatment of infectious aneurysms might be an advantage in therapy in these patients.


METHODS
We present a patient with ruptured infectious intracranial aneurysm complicating endocarditis with hemorrhage after successful coil occlusion of the aneurysm and review the literature on studies reporting endovascular treatment in adults with infectious aneurysms.


RESULTS
In total 34 adults have been reported with endovascular treatment of infectious aneurysms. All patients were initially presented with hemorrhage. Reported mortality rate was low (6%), and neurologic disability was reported in 37% of other patients. Rehemorrhage has been described in one other patient after endovascular treatment of an infectious aneurysm after rupture of a new aneurysm. In our patient, CT suggested a generalized cerebral infectious vasculitis.


CONCLUSIONS
Endovascular treatment of infectious aneurysms seems to be a great advantage, but endovascular coiling may not prevent hemorrhage associated with panvasculitis rupture of a new aneurysm.
van de Beek
Diederik
D
Division of Critical Care Neurology, Department of Neurology, Mayo Clinic College of Medicine, W8B, 200 First Street SW, Rochester, MN 55905, USA.
Rabinstein
Alejandro A
AA
Peters
Steve G
SG
Cloft
Harry
H
Wijdicks
Eelco F M
EF
D000328:Adult; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D015901:Angiography, Digital Subtraction; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D004621:Embolization, Therapeutic; D004697:Endocarditis, Bacterial / Q000150:complications*; D006801:Humans; D002532:Intracranial Aneurysm; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D013203:Staphylococcal Infections / Q000150:complications*; D014057:Tomography, X-Ray Computed; D020293:Vasculitis, Central Nervous System / Q000150:complications* / Q000000981:diagnostic imaging