Successful coil embolization of a ruptured mycotic aneurysm that developed three days after septic embolic infarction: Case report and review of the literature.

BACKGROUND

Infectious intracranial aneurysms (IIAs) are rare entities and are often associated with septic embolus from infectious endocarditis. They may develop rapidly and carry a higher risk of rupture and mortality compared to noninfectious aneurysms. However, the development and rupture of an IIA within 48h in a patient with septic infarction patient is exceedingly rare.

CASE DESCRIPTION

In this report, we describe a 25-year-old male who presented with left-sided hemiparesis and dysarthria from septic embolus to the right middle cerebral artery. Thirty-nine hours after presentation, he became encephalopathic following a witnessed seizure. Angiography demonstrated a new, ruptured aneurysm, which was successfully treated with endovascular coil embolization. Our study documents the first report of coil embolization in a rapidly developed infectious aneurysm.

CONCLUSIONS

Importantly, this case demonstrates that septic infarction may precede and herald IIA development and rupture. If IIA is detected due to rupture, coil embolization can be a safe and effective therapy.