Acute enlargement, morphological changes, and rupture of intracranial infectious aneurysm in infective endocarditis. Serial imaging - Université Sorbonne Paris Nord Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Neuroscience Année : 2020

Acute enlargement, morphological changes, and rupture of intracranial infectious aneurysm in infective endocarditis. Serial imaging

Résumé

A 72-year-old man received a transcatheter aortic valve implantation (TAVI) 2 years ago for leakage of the degenerative bioprosthesis with Corevalve n°31 implantation, presented infective endocarditis (IE) (streptococcus sanguinis) of the bioprosthetic aortic valve. One month after antibiotic treatment was initiated, he presented a left-sided hemiplegia, a right frontal hematoma. MRI/contrast-enhanced magnetic resonance angiography (CE-MRA) revealed 2 infectious intracranial aneurysms (IIAs) of the right (10 mm) and left middle cerebral artery (MCA) (M2 segment, 5 mm). The right MCA IIA was treated within 1 day by glue-embolization. Seven days later, the patient acutely developed motor aphasia. CE-MRA showed significant enlargement (15 mm) and morphologic change of the ruptured left MCA IIA. This IIA was treated with Onyx-embolization. This case adds additional evidence that IIAs, during IE, can show rapid growth and morphological change over a 7 day course and emphasizes the imperative need of close imaging follow-up when IIAs are managed by antibiotic therapy.
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Dates et versions

hal-03492751 , version 1 (15-12-2022)

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Paternité - Pas d'utilisation commerciale

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Monique Boukobza, Olivier Naggara, Xavier Duval, Jean-Pierre Laissy. Acute enlargement, morphological changes, and rupture of intracranial infectious aneurysm in infective endocarditis. Serial imaging. Journal of Clinical Neuroscience, 2020, 82, pp.237 - 240. ⟨10.1016/j.jocn.2020.11.001⟩. ⟨hal-03492751⟩
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