title: Endovascular Therapy for Infectious Intracranial Aneurysm: A Report of Four Cases.
abstract: BACKGROUND
  Infectious intracranial aneurysms (IIAs) are rare but can cause substantial morbidity and mortality. We aimed to re-evaluate the role of endovascular therapy for the treatment of IIAs.
  
  
  METHODS
  This study is a retrospective review of patients diagnosed with IIAs and treated by endovascular therapy in our institutions over the past 13 years.
  
  
  RESULTS
  Four patients were diagnosed with infectious endocarditis with a total of 5 IIAs. Three of the 4 patients had ruptured IIAs. Two presented with intracerebral hemorrhage, one with subarachnoid hemorrhage, and one with cerebral infarction. The distal middle cerebral artery (MCA) was the most common site, followed by the distal segment of the posterior cerebral artery. Three patients were treated by parent artery occlusion and one by direct aneurysm obliteration. There were no periprocedural complications. One IIA treated by direct aneurysm occlusion was recanalized within 1 year and required a second embolization. Outcomes were measured by the modified Rankin Scale on discharge: 2 patients scored 0, 1 patient scored 1, and 1 patient scored 3.
  
  
  CONCLUSIONS
  IIAs located deep in the brain or on the peripheral MCA can be safely treated with endovascular therapy even when they are lying in the eloquent cortex.
authors.affiliation: Department of Neurosurgery, Juntendo University Urayasu Hospital, Urayasu, Japan. Electronic address: snonaka@juntendo.ac.jp.
authors.forename: Senshu
authors.initials: S
authors.lastname: Nonaka
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, Urayasu, Japan; Department of Neuroendovascular Therapy, Juntendo University School of Medicine, Urayasu, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Oishi
authors.affiliation: Department of Neurosurgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tsutsumi
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, Urayasu, Japan.
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Teranishi
authors.affiliation: Department of Neuroendovascular Therapy, Juntendo University School of Medicine, Urayasu, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tanoue
authors.affiliation: Department of Neurosurgery, Juntendo University Urayasu Hospital, Urayasu, Japan.
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Yasumoto
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, Urayasu, Japan.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Neurosurgery, Juntendo University School of Medicine, Urayasu, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Arai
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D007239:Infections / Q000150:complications*; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Infectious intracranial aneurysm; bacterial endocarditis; coil embolization; modified Rankin Scale