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颅内霉菌性动脉瘤破裂表现为脑出血和蛛网膜下腔出血:2例报告

Intracerebral hemorrhage and subarachnoid hemorrhage as a manifestation of ruptured intracranial mycotic aneurysms: A report of 2 cases.

作者信息

Biyang Yunita Ch, Sani Achmad F, Kurniawan Dedy

机构信息

Department of Neurology, Faculty of Medicine, Airlangga University, Surabaya, Indonesia.

Department of Neurology, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

出版信息

Radiol Case Rep. 2024 Aug 17;19(11):4983-4988. doi: 10.1016/j.radcr.2024.07.139. eCollection 2024 Nov.

Abstract

Intracranial mycotic aneurysms (IMA) are caused by abnormal dilatation of brain vessels due to infective dissemination, most often associated with endocarditis vegetation. This condition is relatively rare, accounting for approximately 0.7%-5.4% of all intracranial aneurysms. However, the related morbidity and mortality levels are high due to the occurrence of intracranial (ICH) and subarachnoid hemorrhage (SAH). We report 2 cases of intracranial mycotic aneurysms that presented to us with features of ICH and SAH and were managed successfully with endovascular therapy. Presently, there are no standardized recommendations for determining the clinical diagnosis and therapy of intracranial mycotic aneurysms. Hence, the treatment given to patients varies greatly. However, it is crucial to achieve a proper diagnosis and initiate early aggressive therapy to improve the prognosis of patients. Endovascular therapy and surgical techniques are safe and effective options with higher survival rates than single-conservative management.

摘要

颅内真菌性动脉瘤(IMA)是由感染性播散导致脑血管异常扩张引起的,最常与感染性心内膜炎赘生物相关。这种情况相对罕见,约占所有颅内动脉瘤的0.7%-5.4%。然而,由于颅内出血(ICH)和蛛网膜下腔出血(SAH)的发生,相关的发病率和死亡率较高。我们报告2例颅内真菌性动脉瘤,以ICH和SAH为特征就诊,并通过血管内治疗成功治愈。目前,对于颅内真菌性动脉瘤的临床诊断和治疗尚无标准化建议。因此,给予患者的治疗差异很大。然而,进行正确诊断并尽早积极治疗对于改善患者预后至关重要。血管内治疗和外科技术是安全有效的选择,生存率高于单一保守治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc41/11378101/bfbfbfdfbcb1/gr1.jpg

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