title: The only case of mycotic aneurysm of the PICA: Clinical-radiological remarks and review of literature.
abstract: We present the first and only case, reported in literature, of a 67-years-old man with a mycotic aneurysm (MA) of the left posterior inferior cerebellar artery (PICA), caused by group B Streptococcus, that we surgically treated, performing neck aneurysm clipping, preserving patency of parent vessel. Moreover the peculiarity of this case is represented by the fact that the MA is originated from a tooth abscess, treated about two years before. To date, there have been only 10 cases of association between MA with either tooth pathologies or dental surgical procedures and our case is the only one originating from PICA. Therefore an extensive literature analysis was performed. Hence if we observe a patient with a fusiform aneurysm in posterior intracranial circulation and clinical history of fever and/or persistent neck swelling after dental pathologies, it is mandatory to consider the possibility of a MA, for a correct differential diagnosis. If the diagnosis is confirmed, it is necessary to research the origin of infection and to set the specific antibiotics therapy.
authors.affiliation: Department of Neurology and Psichiatry-Neurosurgery, "La Sapienza" University of Rome, Italy.
authors.forename: Manolo
authors.initials: M
authors.lastname: Piccirilli
authors.affiliation: Department of Neurology and Psichiatry-Neurosurgery, "La Sapienza" University of Rome, Italy.
authors.forename: Emiliano
authors.initials: E
authors.lastname: Prizio
authors.affiliation: Department of Neurology and Psichiatry-Neurosurgery, "La Sapienza" University of Rome, Italy.
authors.forename: Delia
authors.initials: D
authors.lastname: Cannizzaro
authors.affiliation: Department of Neurology and Psichiatry-Neurosurgery, "La Sapienza" University of Rome, Italy. Electronic address: mariapia.tropeano@libero.it.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Tropeano
authors.affiliation: Department of Neurology and Psichiatry-Neurosurgery, "La Sapienza" University of Rome, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Guidetti
authors.affiliation: Department of Neurology and Psichiatry-Neurosurgery, "La Sapienza" University of Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Santoro
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging* / Q000601:surgery; D002531:Cerebellum / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000601:surgery; D002533:Cerebral Angiography / Q000379:methods; D002536:Cerebral Arteries / Q000187:drug effects* / Q000601:surgery; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D013290:Streptococcal Infections / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D013292:Streptococcus agalactiae / Q000302:isolation & purification
keywords: Dental procedures; Endocarditis; Infectious aneurysm; Mycotic aneurysm; PICA; Surgery