title: A case of embolic stroke imitating atherothrombotic brain infarction before massive hemorrhage from an infectious aneurysm caused by Streptococci.
abstract: Early detection followed by treatment with antibiotics in conjunction with direct or endovascular surgery is integral in the management of patients with intracranial infectious aneurysms. These aneurysms often manifest as massive intracranial hemorrhages, which severely deteriorate the outcome. It is very important to detect infectious aneurysms before they rupture. Although usually associated with infective endocarditis, these aneurysms can occur in a variety of clinical settings. We present a case of α-Streptococcus-provoked infectious aneurysm in a patient without infective endocarditis, initially presenting as atherothrombotic-like brain infarction, before massive intracranial hemorrhage. The present case alerts clinicians to keep in mind possible development of infectious aneurysms, even in patients who appear to be suffering from atherothrombotic stoke, especially in patients presenting with signs of infection.
authors: Department of Neurosurgery, Eiju General Hospital, Tokyo, Japan. ryuichi@kj9.so-net.ne.jp
authors: Ryuichi
authors: R
authors: Kanai
authors: Jun
authors: J
authors: Shinoda
authors: Seiichiro
authors: S
authors: Irie
authors: Koji
authors: K
authors: Inoue
authors: Teiko
authors: T
authors: Sato
authors: Yutaka
authors: Y
authors: Tsutsumi
mesh_terms: D000785:Aneurysm, Infected / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D015901:Angiography, Digital Subtraction; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D020520:Brain Infarction / Q000175:diagnosis*; D002533:Cerebral Angiography / Q000379:methods; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D042241:Early Diagnosis; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D020766:Intracranial Embolism / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011237:Predictive Value of Tests; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D020521:Stroke / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
chemical_list: D000900:Anti-Bacterial Agents