Múltiplos aneurismas micóticos intracranianos: registro de um caso

Valadares, João Batista; Souza, Mário T. Kroeff de; Hankinson, John; Hall, Keith; Sengupta, R.

doi:10.1590/S0004-282X1979000300010

Resumos

É relatado o caso de uma paciente com 31 anos de idade com múltiplos aneurismas micóticos intracranianos associados a endocardite bacteriana suba-guda. Os autores discutem os aspectos clínicos-patológicos de tais lesões. A regressão completa de todos os aneurismas após antibioticoterapia favorece uma conduta visando controle adequado da infecção antes de qualquer consideração de tratamento cirúrgico.

The case of a 31 years old woman with multiple intracranial mycotic aneurysms in association with subacute bacterial endocarditis is reported. The authors discuss the clinical and pathological aspects of such lesions. The complete regression of all the aneurysms after antibiotic therapy favours an approach aiming at adequate control of the infection prior to any consideration of surgical treatment.

Múltiplos aneurismas micóticos intracranianos: registro de um caso

Multiple intracranial mycotic aneurysms: a case report

João Batista Valadares^I; Mário T. Kroeff de Souza^II; John Hankinson^III; Keith Hall^IV; R. Sengupta^V

^IRegistrar in Neurosurgery. Regional Neurological Centre, Newcastle General Hospital, Newcastle upon Tyne, England

^IIResident in Neurosurgery. Regional Neurological Centre, Newcastle General Hospital, Newcastle upon Tyne, England

^IIIProfessor of Neurosurgery. Regional Neurological Centre, Newcastle General Hospital, Newcastle upon Tyne, England

^IVConsultant Neuroradiology. Regional Neurological Centre, Newcastle General Hospital, Newcastle upon Tyne, England

^VConsultant Neurosurgeon. Regional Neurological Centre, Newcastle General Hospital, Newcastle upon Tyne, England

RESUMO

É relatado o caso de uma paciente com 31 anos de idade com múltiplos aneurismas micóticos intracranianos associados a endocardite bacteriana suba-guda. Os autores discutem os aspectos clínicos-patológicos de tais lesões. A regressão completa de todos os aneurismas após antibioticoterapia favorece uma conduta visando controle adequado da infecção antes de qualquer consideração de tratamento cirúrgico.

SUMMARY

The case of a 31 years old woman with multiple intracranial mycotic aneurysms in association with subacute bacterial endocarditis is reported. The authors discuss the clinical and pathological aspects of such lesions. The complete regression of all the aneurysms after antibiotic therapy favours an approach aiming at adequate control of the infection prior to any consideration of surgical treatment.

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Trabalho do Regional Neurological Centre, Newcastle General Hospital, Newcastle upon Tyne, England.

Regional Neurological Centre, ward 31 - Newcastle General Hospital - Westgate Road NEU 6BE - Newcastle upon Tyne - England.

1. BELL, W. E. & BUTLER, C. - Cerebral mycotic aneurysms in children: two case reports. Neurology (Minneapolis) 18:81, 1968.
2. BINGAM, W. F. - Treatment of mycotic intracranial aneurysm. J. Neurosurg. 46: 428, 1977.
3. BOHMFALK, G. L.; STORY, J. L.; WISSINGER, J. P. & BROWN, W. E. Jr. - Bacterial intracranial aneurysm. J. Neurosurg. 48:369, 1978.
4. CANTU, R. C; LEMAY, M. L. & WILKINSON, H. A. - The importance of repeated angiography in the treatment of mycotic-embolic intracranial aneurysms. J. Neurosurg. 25:189, 1966.
5. CHERUBIN, C. E. - Infectious disease problems of narcotics addicts. Arch. Int. Med. 128:309, 1971.
6. DAVIDSON, P. & ROBERTSON, D. M. - A true mycotic (aspergillus) aneurysm leading to iatal subarachnoid hemorrhage in a patient with hereditary hemorrhagic telangiectasia: a case report. J. Neurosurg. 35:71, 1971.
7. EPPINGER, H. - Pathogenesis (histogenesis und aetiologie) der Aneurysmen einschliesslich des Aneurysma equi verminosum. Arch. Klin. Chir. 35 (suppl) 1:553, 1837.
8. GILROY, J.; ANDAYA, L, & THOMAS, V. J. - Intracranial mycotic aneurysms and subacute bacterial endocardites in heroin aJdiction. Neurology (Minneapolis) 23:1193, 1973.
9. HANNESON, B. & SACHS, E. JR. - Mycotic aneurysms following purulent meningitis: report of a case with recovery and review of the literatura. Acta Neurochir. 24:805, 1971.
10. HARRISON, M. J. G. & HAPTON, J. R. - Neurological presentation of bacterial endocarditis. Brit. Med. J. 2:148, 1967.
11. HOURIHANE, J. B. - Ruptured mycotic intracranial aneurysm: a report of three cases. Vase. Surg. 4:21, 1970.
12. HOUSEPIAN, E. M. & POOL, J. L. - A systematic analysis of intracranial aneurysms from the autopsy tile of the Presbiterian Hospital 1914 to 1956. J. Neuropath, exp. Neurol. 17:409, 1958.
13. ISHIKAWA, M.; WAG A, S.; MORITAKE, K. & HANDA, M. - Cerebral bacterial aneurysms: report of three cases. Surg. Neurol. 2:257, 1974.
14. JONES, H. R. JR.; SIEKERT, R. G. & GERACI, J. E. - Neurologic manifestations of bacterial endocarditis. Ann. Int. Med. 71:21, 1969.
15. KIRKES, W. S. - On some of principal effects resulting from the detachment of fibrinous deposits from the interior of the heart and their mixture with the circulating blood. Med. Chir. Tr. 35:281, 1852.
16. McDONALD, C. A. & KORB, M. - Intracranial aneurysms. Arch. Neurol. Psychiat. (Chicago) 42:298, 1939.
17. MOLINARI, C. F. - Septic cerebral embolism. Stroke 3:117, 1972.
18. MOLINARI, C. F.; SMITH, L.; GOLDSTEIN, M. N. & SATRAN, R. - Pathogenesis of cerebral mycotic aneurysms. Neurology (Minneapolis) 23:325, 1972.
19. OSLER, M. - Gulstonian lectures on malignant endocarditis. Lancet 1:415, 459, 505, 1885.
20. ROACH, M. R. & DRAKE, C. C. - Ruptured cerebral aneurysms caused by micro-organisms. New Engl. J. Med. 273:240, 1965.
21. STENGEL, A. & WOLFERTH, C. C. - Mycotic bacterial aneurysms of inrta-vascular origin. Arch. Int. Med. 31:527, 1923.
22. VIRCHOW, R. VON - Ueber die Akute Entzündung der Arterien. Virchows Path. Anat. 1:272, 1847.

Datas de Publicação

Publicação nesta coleção
21 Ago 2012
Data do Fascículo
Set 1979

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BELL, W. E. & BUTLER, C. - Cerebral mycotic aneurysms in children: two case reports. Neurology (Minneapolis) 18:81, 1968.

[2] 2. BINGAM, W. F. - Treatment of mycotic intracranial aneurysm. J. Neurosurg. 46: 428, 1977.

[3] 3. BOHMFALK, G. L.; STORY, J. L.; WISSINGER, J. P. & BROWN, W. E. Jr. - Bacterial intracranial aneurysm. J. Neurosurg. 48:369, 1978.

[4] 4. CANTU, R. C; LEMAY, M. L. & WILKINSON, H. A. - The importance of repeated angiography in the treatment of mycotic-embolic intracranial aneurysms. J. Neurosurg. 25:189, 1966.

[5] 5. CHERUBIN, C. E. - Infectious disease problems of narcotics addicts. Arch. Int. Med. 128:309, 1971.

[6] 6. DAVIDSON, P. & ROBERTSON, D. M. - A true mycotic (aspergillus) aneurysm leading to iatal subarachnoid hemorrhage in a patient with hereditary hemorrhagic telangiectasia: a case report. J. Neurosurg. 35:71, 1971.

[7] 7. EPPINGER, H. - Pathogenesis (histogenesis und aetiologie) der Aneurysmen einschliesslich des Aneurysma equi verminosum. Arch. Klin. Chir. 35 (suppl) 1:553, 1837.

[8] 8. GILROY, J.; ANDAYA, L, & THOMAS, V. J. - Intracranial mycotic aneurysms and subacute bacterial endocardites in heroin aJdiction. Neurology (Minneapolis) 23:1193, 1973.

[9] 9. HANNESON, B. & SACHS, E. JR. - Mycotic aneurysms following purulent meningitis: report of a case with recovery and review of the literatura. Acta Neurochir. 24:805, 1971.

[10] 10. HARRISON, M. J. G. & HAPTON, J. R. - Neurological presentation of bacterial endocarditis. Brit. Med. J. 2:148, 1967.

[11] 11. HOURIHANE, J. B. - Ruptured mycotic intracranial aneurysm: a report of three cases. Vase. Surg. 4:21, 1970.

[12] 12. HOUSEPIAN, E. M. & POOL, J. L. - A systematic analysis of intracranial aneurysms from the autopsy tile of the Presbiterian Hospital 1914 to 1956. J. Neuropath, exp. Neurol. 17:409, 1958.

[13] 13. ISHIKAWA, M.; WAG A, S.; MORITAKE, K. & HANDA, M. - Cerebral bacterial aneurysms: report of three cases. Surg. Neurol. 2:257, 1974.

[14] 14. JONES, H. R. JR.; SIEKERT, R. G. & GERACI, J. E. - Neurologic manifestations of bacterial endocarditis. Ann. Int. Med. 71:21, 1969.

[15] 15. KIRKES, W. S. - On some of principal effects resulting from the detachment of fibrinous deposits from the interior of the heart and their mixture with the circulating blood. Med. Chir. Tr. 35:281, 1852.

[16] 16. McDONALD, C. A. & KORB, M. - Intracranial aneurysms. Arch. Neurol. Psychiat. (Chicago) 42:298, 1939.

[17] 17. MOLINARI, C. F. - Septic cerebral embolism. Stroke 3:117, 1972.

[18] 18. MOLINARI, C. F.; SMITH, L.; GOLDSTEIN, M. N. & SATRAN, R. - Pathogenesis of cerebral mycotic aneurysms. Neurology (Minneapolis) 23:325, 1972.

[19] 19. OSLER, M. - Gulstonian lectures on malignant endocarditis. Lancet 1:415, 459, 505, 1885.

[20] 20. ROACH, M. R. & DRAKE, C. C. - Ruptured cerebral aneurysms caused by micro-organisms. New Engl. J. Med. 273:240, 1965.

[21] 21. STENGEL, A. & WOLFERTH, C. C. - Mycotic bacterial aneurysms of inrta-vascular origin. Arch. Int. Med. 31:527, 1923.

[22] 22. VIRCHOW, R. VON - Ueber die Akute Entzündung der Arterien. Virchows Path. Anat. 1:272, 1847.

Brasil

Brasil

Múltiplos aneurismas micóticos intracranianos: registro de um caso

Multiple intracranial mycotic aneurysms: a case report

Resumos

Datas de Publicação