Aneurysm, Mycotic

Intracranial mycotic aneurysms, AKA infectious aneurysms, develop secondary to arterial wall infections. They are most common in the distal MCA branches.

Cases

1

A patient with a history of MSSA bacteremia presented with severe headache and left hemiparesis. CT head showed a large right frontal ICH, and CTA head showed a peripheral right MCA mycotic aneurysm. The patient subsequently underwent a right craniotomy and clipping of the aneurysm. Post-op DSA showed complete occlusion of the aneurysm.

(A): Axial CT head without contrast.
(B): Coronal CT head without contrast.
(C): Sagittal CT head without contrast.
(D): Axial CTA head.
(E): Coronal CTA head.
(F): Sagittal CTA head.
(G and H): 3D reconstruction of pre-op CTA head.
(I): PA view of post-op DSA.
(J): Lateral view of post-op DSA.
(K and L): 3D reconstruction of post-op CTA head.