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Malignant clinical course of mycotic intracranial aneurysms in children: A review

BACKGROUND: Mycotic aneurysms are a rare in the pediatric population. The natural history of these lesions and their appropriate management strategies is controversial. CASE DESCRIPTION: A 13-year-old male presented with the sudden onset of a headache, vomiting, and fever. Inflammatory markers were...

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Autores principales: Khormi, Yahya H, Tyndall, Ronette Goodluck, Tamber, Mandeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193218/
https://www.ncbi.nlm.nih.gov/pubmed/32363066
http://dx.doi.org/10.25259/SNI_560_2019
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author Khormi, Yahya H
Tyndall, Ronette Goodluck
Tamber, Mandeep
author_facet Khormi, Yahya H
Tyndall, Ronette Goodluck
Tamber, Mandeep
author_sort Khormi, Yahya H
collection PubMed
description BACKGROUND: Mycotic aneurysms are a rare in the pediatric population. The natural history of these lesions and their appropriate management strategies is controversial. CASE DESCRIPTION: A 13-year-old male presented with the sudden onset of a headache, vomiting, and fever. Inflammatory markers were elevated, and the blood culture was positive for Streptococcus viridans. When the computed tomography angiography (CTA) showed a ruptured mycotic aneurysm accompanied by multiple small unruptured aneurysms, he was started on antibiotics and underwent an urgent craniotomy. Despite negative blood cultures, the follow-up CTA showed further enlargement of the previously diagnosed aneurysms and a new right frontal aneurysm. The second and third craniotomies were, respectively, performed to resect the additional aneurysms. Pathologically, both aneurysmal walls were markedly inflamed and attenuated, suggesting the imminent risk of aneurysmal rupture. Following the total of three craniotomies, the patient had an uneventful postoperative course. Within 2 weeks, he regained baseline neurological function. CONCLUSION: Mycotic aneurysms in children may follow a very malignant course. Aneurysms may grow, new ones may form, and repeated CTAs are required to direct further follow-up treatment.
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spelling pubmed-71932182020-05-01 Malignant clinical course of mycotic intracranial aneurysms in children: A review Khormi, Yahya H Tyndall, Ronette Goodluck Tamber, Mandeep Surg Neurol Int Case Report BACKGROUND: Mycotic aneurysms are a rare in the pediatric population. The natural history of these lesions and their appropriate management strategies is controversial. CASE DESCRIPTION: A 13-year-old male presented with the sudden onset of a headache, vomiting, and fever. Inflammatory markers were elevated, and the blood culture was positive for Streptococcus viridans. When the computed tomography angiography (CTA) showed a ruptured mycotic aneurysm accompanied by multiple small unruptured aneurysms, he was started on antibiotics and underwent an urgent craniotomy. Despite negative blood cultures, the follow-up CTA showed further enlargement of the previously diagnosed aneurysms and a new right frontal aneurysm. The second and third craniotomies were, respectively, performed to resect the additional aneurysms. Pathologically, both aneurysmal walls were markedly inflamed and attenuated, suggesting the imminent risk of aneurysmal rupture. Following the total of three craniotomies, the patient had an uneventful postoperative course. Within 2 weeks, he regained baseline neurological function. CONCLUSION: Mycotic aneurysms in children may follow a very malignant course. Aneurysms may grow, new ones may form, and repeated CTAs are required to direct further follow-up treatment. Scientific Scholar 2020-04-18 /pmc/articles/PMC7193218/ /pubmed/32363066 http://dx.doi.org/10.25259/SNI_560_2019 Text en Copyright: © 2020 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Khormi, Yahya H
Tyndall, Ronette Goodluck
Tamber, Mandeep
Malignant clinical course of mycotic intracranial aneurysms in children: A review
title Malignant clinical course of mycotic intracranial aneurysms in children: A review
title_full Malignant clinical course of mycotic intracranial aneurysms in children: A review
title_fullStr Malignant clinical course of mycotic intracranial aneurysms in children: A review
title_full_unstemmed Malignant clinical course of mycotic intracranial aneurysms in children: A review
title_short Malignant clinical course of mycotic intracranial aneurysms in children: A review
title_sort malignant clinical course of mycotic intracranial aneurysms in children: a review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193218/
https://www.ncbi.nlm.nih.gov/pubmed/32363066
http://dx.doi.org/10.25259/SNI_560_2019
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