Introduction: Infectious intracranial aneurysm (IIA, or mycotic aneurysm) is a cerebrovascular complication of infective endocarditis. We aimed to describe the clinical course of IIAs during antibiotic treatment.
Methods: We reviewed medical records of persons with infective endocarditis who underwent cerebral angiography at a single tertiary referral center from 2011 to 2016. Aneurysms were followed with subsequent angiography for unfavorable outcome (growth, rupture, no change, or new IIA formation) or favorable outcome (regression or resolution) until endovascular therapy, aneurysm resolution, or end of observation.
Results: Of 618 patients included, 40 (6.5%) had 43 IIAs. Eighteen (42%) aneurysms underwent initial endovascular treatment. Twenty-five unruptured aneurysms were followed for a median 18 antibiotic days after IIA discovery (interquartile range [IQR] 4-32). Eleven (44%) aneurysms had unfavorable outcome (1 rupture, 2 new IIA formation, 6 enlargement, and 2 no change) at median 21 days (IQR 5-32). Favorable angiographic outcome was seen in 7 (28%) patients (6 resolution, 1 regression) at median 36 days (IQR 24-41). Seven aneurysms had no angiographic reevaluations but showed no evidence of rupture during clinical follow-up for median 4 days (IQR 3-12) until hospital discharge. Saccular morphology was associated with unfavorable aneurysmal outcome (p = 0.013). Longer duration of antibiotic exposure prior to IIA discovery was associated with favorable aneurysmal outcome (p = 0.046).
Conclusion: IIAs represent a dynamic disease. Only a quarter of IIAs resolve with antibiotics alone. Saccular aneurysmal morphology might predict unfavorable aneurysmal outcome. IIA found after longer antibiotic therapy has higher likelihood of resolution or regression on antibiotic treatment.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jns.2019.06.004 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
One-year outcome and quality of life of patients with subarachnoid hemorrhage admitted to intensive care unit: a single-center retrospective pilot study.
J Anesth Analg Crit Care
January 2025
Department of Emergency Surgery and Trauma, Anesthesia and Intensive Care Unit, Bufalini Hospital, Azienda Unità Sanitaria Locale (AUSL) Della Romagna, Cesena, Italy.
Patients admitted to intensive care unit (ICU) after non-traumatic subarachnoid hemorrhage (SAH) represent a group with distinctive characteristics and few data are available on long-term outcome in this population. We conducted a single-center retrospective study in an Italian intensive care unit. All patients with non-traumatic SAH (ICD-9-CM Diagnosis Code 430) admitted to ICU were included.
View Article and Find Full Text PDFJoint analysis of blood pressure changes over time and survival of hypertensive patients under treatment at Sawula hospital in Southern Ethiopia.
BMC Public Health
January 2025
Department of Statistics, Borana University, Borena, Oromia Region, Ethiopia.
Introduction: Hypertension is among the most significant non-communicable public health issues worldwide. High blood pressure, or hypertension, has been associated with severe health consequences, including death, aneurysms, stroke, chronic renal disease, eye damage, heart attack, heart failure, peripheral artery disease, and vascular dementia. Consequently, this study aimed to investigate the predictors linked to survival time and the progression of blood pressure measurements in hypertensive patients.
View Article and Find Full Text PDFClazosentan's dual edge in managing vasospasm following aneurysmal subarachnoid hemorrhage: an updated systematic review, meta-analysis, and meta-regression of clinical outcomes and safety profiles.
Neurosurg Rev
January 2025
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Aneurysmal Subarachnoid Hemorrhage (aSAH), resulting from ruptured aneurysms, is a major contributor to stroke-related mortality and morbidity. Despite advances in healthcare, aSAH remains severe and often leads to complications such as cerebral vasospasm (CV), cerebral infarction, and delayed ischemic neurological deficits (DIND). Clazosentan, an endothelin receptor antagonist, has demonstrated potential in alleviating vasospasm and its associated outcomes, although evidence of its efficacy remains unclear.
View Article and Find Full Text PDFThe Artisse intrasaccular device for the treatment of cerebral aneurysms: initial experience from three Austrian neurovascular centers.
J Neurointerv Surg
January 2025
Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
Background And Purpose: This study evaluates the early clinical performance of the new Artisse Intrasaccular Device (Artisse ISD), a self-expandable intrasaccular flow diverter, for treating wide-necked aneurysms (WNAs). We report initial safety and efficacy outcomes in the first cohort of patients treated with this novel device.
Methods: Prospective clinical and radiological data were collected for all patients treated with the Artisse ISD at three Austrian neurovascular centers from July 2023 to August 2024.
Prediction of the need for surgery in patients with unruptured abdominal aortic aneurysm based on SOFA score.
PLoS One
January 2025
General Surgery, Cancer Center, Department of Vascular Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Objective: This retrospective study aimed to explore the association and clinical value of sequential organ failure assessment (SOFA) score on the predictors of adverse events in patients with unruptured abdominal aortic aneurysms (AAA).
Methods: A total of 322 patients from Medical Information Mart for Intensive Care IV database were enrolled. Logistic regression was conducted to explore the association between SOFA and primary outcome (need for surgery, NFS).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!