EURORAD ESR

Case 14437

Cerebral Mycotic Aneurysm in the Setting of Infective Endocarditis

Author(s)
Margaux M McConn BA, Zain Badar MD, Zareen Razaq MBBS, Sajeev Ezhapilli MBBS

SUNY Upstate Medical Center, SUNY Upstate Medical Center, Radiology; 750 E Adams street 13210 Syracuse; Email:badarz@upstate.edu
 
Patient
male, 34 year(s)
 
 
  • Figure 1
    Figure 1

    Axial DWI image demonstrates foci of restricted diffusion in the right caudate head and right temporal lobe (orange arrows)(A). Axial T2 flair image demonstrates subarachnoid haemorrhage in right frontoparietal lobe...

     
    Area of Interest: Vascular; Imaging Technique: CT; Procedure: Angioplasty; Special Focus: Acute;
     
     
  • Figure 2
    Figure 2

    Pre-procedure axial CTA demonstrates aneurysm (green arrow) of the distal MCA branch (A). Additionally, 3D volume rendered reconstruction image demonstrates the aneurysm (purple arrow) of the distal M4 branch within...

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT-Angiography; Procedure: Angioplasty; Special Focus: Acute;
     
     
  • Figure 3
    Figure 3

    Pre-procedural conventional angiogram shows a 3mm x 2mm mycotic aneurysm of the distal M4 MCA (red arrows) inaccessible to endovascular route, with the aneurysm demonstrated on sagittal view (A) and on coronal view (B)

     
    Area of Interest: Neuroradiology brain; Imaging Technique: Catheter arteriography; Procedure: Angioplasty; Special Focus: Acute;
     
     
  • Figure 4
    Figure 4

    Intraoperative transfemoral diagnostic cerebral angiogram demonstrates complete occlusion of aneurysm with persistent filling of involved rolandic branch of the right middle cerebral artery with a microsurgical clip...

     
    Area of Interest: Neuroradiology brain; Imaging Technique: Catheter arteriography; Procedure: Angioplasty; Special Focus: Acute;
     
     
Axial DWI image demonstrates foci of restricted diffusion in the right caudate head and right temporal lobe (orange arrows)(A). Axial T2 flair image demonstrates subarachnoid haemorrhage in right frontoparietal lobe (blue arrow) (B)
 
Pre-procedure axial CTA demonstrates aneurysm (green arrow) of the distal MCA branch (A). Additionally, 3D volume rendered reconstruction image demonstrates the aneurysm (purple arrow) of the distal M4 branch within the right parietal lobe (B)
 
Pre-procedural conventional angiogram shows a 3mm x 2mm mycotic aneurysm of the distal M4 MCA (red arrows) inaccessible to endovascular route, with the aneurysm demonstrated on sagittal view (A) and on coronal view (B)
 
Intraoperative transfemoral diagnostic cerebral angiogram demonstrates complete occlusion of aneurysm with persistent filling of involved rolandic branch of the right middle cerebral artery with a microsurgical clip (yellow arrow) in the region of the aneurysm
 
 
 
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