2017 年 11 巻 10 号 p. 497-503
Objective: Aggressive therapeutic intervention is recommended for infectious intracranial aneurysms (IIAs) because they have a higher hemorrhage risk than non-IIAs. In this study, we retrospectively reviewed patients with IIAs treated at our institution and evaluated the contents of treatment and the complications.
Methods: We evaluated 13 patients diagnosed with IIA based on clinical symptoms and imaging findings between March 2004 and December 2014.
Results: Endovascular treatment, direct surgery, and conservative management were performed in five, five, and three patients, respectively. In endovascular treatment patients, none developed any hemorrhagic or infectious complications. In the five direct surgery patients, we selected direct surgery because three patients needed hematoma evacuation, and the catheter navigation was not achievable in the remaining two patients.
Conclusion: Since IIAs often occur in peripheral arteries and are accompanied by local infection, aneurysmectomy by direct surgery used to be preferred. However, as embolization of cortical branches using a flexible catheter and small coils has become technically possible by the improvements of endovascular devices, endovascular parent artery occlusion might be a reasonable alternative for IIAs.