Intracranial infectious

Kannoth S, Iyer R, Thomas SV, Furtado SV, Rajesh BJ, Kesa-vadas C, Radhakrishnan VV, Sarma PS (2007) Intracranial infectious aneurysm presentation, management and outcome. J Neurol Sci 256(l/2) 3-9. Epub 2007 Mar 23 Kassell NF, Torner JC (1983) Size of intracranial aneurysms. Neurosurgery 12 291-297... 

The first infectious intracranial aneurysm was probably described by Church in 1869 when he established a relationship between an intracranial aneurysm and infectious endocarditis. The term infectious aneurysm should be preferred bacterial or mycotic should be used only if bacteria or fungi are demonstrated as the causative organisms. The frequently used term mycotic is misleading in the vast majority of patients because bacterial infection represents the most common cause for infectious... 

The course of infectious aneurysms is unpredictable. Under antibiotic or antimycotic therapy they may shrink, or completely disappear. However, enlargement during treatment has also been reported (Brust et al. 1990). Septic aneurysms can be obliterated surgically or by endovascular treatment (Chapot et al. 2002 Phuong et al. 2002 Steinberg et al. 1992). The theoretical assumption that implantation of foreign material - like platinum coils - into an infectious lesion might worsen the problem is not true for infectious intracranial aneurysms. Mortality due to rupture of bacterial cerebral aneurysms is reported to be up to 60% (Barrow and Prats 1990 Bohmfalk et al. 1978 Clare and Barrow 1992). 

Clare CE, Barrow DL (1992) Infectious intracranial aneurysms. Neurosurg Clin North Am 3 551-566 Cloft HJ (2007) HEAL Investigators. HydroCoil for Endovascular Aneurysm Occlusion (HEAL) study 3-6 month angiographic follow-up results. AJNR Am J Neuroradiol 28(1) 152-154... 

Although there should be some concern in performing cranial osteopathy in patients with intracranial bleeding, the extreme nature of this situation relatively lessened the contraindications. The bleeding was confined to a closed space and there was a tamponading process in effect "The decrease in blood pressure was not caused by the blood loss but was related to the cardiac arrhythmia. The compression of the brain parenchyma was responsible for the hyperpyrexia. Insufficient time and the suddenness in the increase in his temperature precluded the likelihood of an infectious cause. 

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