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Angiography in the Management of Intracranial Mycotic Aneurysms

Irwin Ziment, MB, MRCP; B. Lamar Johnson Jr., MD
Arch Intern Med. 1968;122(4):349-352. doi:10.1001/archinte.1968.00300090059013.
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Neurologic abnormalities during the course of bacterial endocarditis have been observed in as many as half the cases in some series.1 Although mycotic aneurysm is one of the less common neuropathologic lesions in such cases, it is of particular importance because of the potential danger of lethal subarachnoid hemorrhage from this lesion which is often amenable to surgical excision. The present report of three patients with cerebral mycotic aneurysm will emphasize the following: (1) the clinical features and cerebrospinal fluid (CSF) findings that may be produced by a mycotic aneurysm prior to major hemorrhage; (2) the urgency of performing carotid angiography if there are clinical indications that this lesion may be present; and (3) the value of surgical treatment of intracranial mycotic aneurysms in many cases.

Patient Summaries 

Patient 1.  —A 52-year-old white man was admitted to the University of California at Los Angeles (UCLA) Hospital on Feb 19,


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