Aoyagi S, Kosuga K, Tanaka K, Nishi Y, Ohishi K
Second Department of Surgery, Kurume University, School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1988 Oct;89(10):1730-3.
A 49 year-old woman was hospitalized with headache and left-sided weakness. Computed tomographic scan and carotid angiogram revealed mycotic aneurysms of the bilateral middle cerebral artery with intracranial bleeding. Although all blood cultures were sterile, her physical examination suspected mitral regurgitation due to infective endocarditis and mycotic cerebral aneurysms. Severe congestive heart failure developed immediately after successful clipping for ruptured mycotic aneurysm of the right middle cerebral artery and then mitral valve replacement with prosthetic valve was performed 3 months after craniotomy. At operation, infective endocarditis on the mitral valve was confirmed. Her postoperative course was uneventful and the second craniotomy for aneurysm of the left middle cerebral artery has been planning.
一名49岁女性因头痛和左侧肢体无力入院。计算机断层扫描和颈动脉血管造影显示双侧大脑中动脉霉菌性动脉瘤伴颅内出血。尽管所有血培养均无菌，但她的体格检查怀疑因感染性心内膜炎和霉菌性脑动脉瘤导致二尖瓣反流。在成功夹闭右侧大脑中动脉破裂的霉菌性动脉瘤后，立即出现了严重的充血性心力衰竭，然后在开颅术后3个月进行了二尖瓣人工瓣膜置换术。手术中证实二尖瓣存在感染性心内膜炎。她的术后过程平稳，目前正在计划对左侧大脑中动脉动脉瘤进行第二次开颅手术。
