title: Endovascular treatment of intracranial infectious aneurysms.
abstract: BACKGROUND
  Intracranial infectious aneurysm (IIA) accounts for less than 5% of all intracranial aneurysms. The aim of this study was to evaluate the role of endovascular treatment for IIA.
  
  
  METHODS
  During a 14-year period, 15 patients (age range, 2-68 years; mean, 42.8 years) with 17 aneurysms were diagnosed with IIA and treated via an endovascular route at our institution. The IIA diagnosis was based on clinical and laboratory findings of infection, echocardiography results, and digital subtraction angiography that were collected retrospectively. All patients were clinically and radiologically followed. The modified Rankin scale was used to evaluate clinical outcome.
  
  
  RESULTS
  Among 15 patients, 12 presented with ruptured aneurysms (7 intraparenchymal hematoma, 4 subarachnoid hemorrhage, 1 subdural hematoma), 2 with cerebral infarcts, and 1 with pansinusitis and epidural abscess. All but one aneurysm were distally located in intracranial circulation, 14 were in anterior, and the remaining 3 were in posterior circulation. The final diagnosis was based on aneurysm morphology, location, and clinical laboratory findings. Endovascular treatment was scheduled initially for all IIAs; 13 of 17 IIAs underwent endovascular parent vessel occlusion, 3 underwent spontaneous parent vessel occlusion while waiting for intervention, and the remaining patient was treated by intrasaccular coil occlusion. There were no instances of perioperative neurological complications. Late clinical and radiological outcomes included absence of endovascular treatment related to mortality and aneurysm recurrence.
  
  
  CONCLUSIONS
  Endovascular treatment may be performed safely at the time of diagnosis for at least symptomatic IIAs under the protective effect of antibiotic treatment.
authors.affiliation: Trakya University Medical Faculty, Department of Radiology, Division of Interventional Radiology, 22030, Edirne, Turkey. asimesenkaya@hotmail.com.
authors.forename: Asim
authors.initials: A
authors.lastname: Esenkaya
authors.affiliation: Celal Bayar University Medical Faculty, Department of Radiology, Manisa, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Duzgun
authors.affiliation: Ege University Medical Faculty, Department of Radiology, Division of Interventional Radiology, Izmir, Turkey.
authors.forename: Celal
authors.initials: C
authors.lastname: Cinar
authors.affiliation: Ege University Medical Faculty, Department of Radiology, Division of Interventional Radiology, Izmir, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Bozkaya
authors.affiliation: Ege University Medical Faculty, Department of Radiology, Division of Neuroadiology, Izmir, Turkey.
authors.forename: Cenk
authors.initials: C
authors.lastname: Eraslan
authors.affiliation: Ege University Medical Faculty, Department of Neurosurgery, Izmir, Turkey.
authors.forename: Erkin
authors.initials: E
authors.lastname: Ozgiray
authors.affiliation: Ege University Medical Faculty, Department of Radiology, Division of Interventional Radiology, Izmir, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Oran
mesh_terms: D000328:Adult; D000368:Aged; D000785:Aneurysm, Infected / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D006490:Hemostatics
keywords: Endovascular treatment; Intracranial infectious aneurysm; Intracranial mycotic aneurysm