gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

Management of patients suffering from infectious intracranial aneurysms – an institutional series and a systematic review of the literature

Meeting Abstract

  • Alexis Hadjiathanasiou - Klinik und Poliklinik für Neurochirurgie, Rheinische Friedrich-Universität Bonn, Germany
  • Patrick Schuss - Klinik und Poliklinik für Neurochirurgie, Rheinische Friedrich-Universität Bonn, Germany
  • Valeri Borger - Klinik und Poliklinik für Neurochirurgie, Rheinische Friedrich-Universität Bonn, Germany
  • Christian Wispel - Klinik und Poliklinik für Neurochirurgie, Rheinische Friedrich-Universität Bonn, Germany
  • Hartmut Vatter - Klinik und Poliklinik für Neurochirurgie, Rheinische Friedrich-Universität Bonn, Germany
  • Erdem Güresir - Klinik und Poliklinik für Neurochirurgie, Rheinische Friedrich-Universität Bonn, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.16.06

doi: 10.3205/16dgnc193, urn:nbn:de:0183-16dgnc1934

Veröffentlicht: 8. Juni 2016

© 2016 Hadjiathanasiou et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Infectious intracranial aneurysms (IIA) represent a rare clinical entity with high mortality. However, data on management of patients suffering from IIAs is scarce. Therefore, we analyzed data of patients suffering from IIAs treated at the author’s institution and performed a systematic review of the literature.

Method: Between 2009 and 2015, 4 consecutive patients with infectious intracranial aneurysms were treated at the author’s institution. To gain a larger population, PubMed was searched for published studies or case series on patients with IIAs. Data including patient characteristics, radiological features, treatment modality, postoperative complications, medical treatment, as well as functional outcome was assessed and further analyzed. Outcome was dichotomized into favorable outcome (mRS 0-2) versus unfavorable outcome (mRS 3-6).

Results: Literature data, including the current series revealed a total of 79 aneurysms in 69 patients. Overall, favorable outcome was achieved in 35 of 69 patients (50%). 24% of patients suffering from IIA were treated conservatively with best medical treatment including antibiotic/antifungal therapy, 33% were treated surgically, and 43% were treated endovascular. Favorable outcome was achieved significantly more often in patients who were treated by clipping or coiling compared to patients treated only conservatively (p=0.02). However, surgical and endovascular treatment did not significantly differ in respect of functional outcome. However, additional antibiotic treatment was administered in 77% of the included patients.

Conclusions: Data of the present study suggests that surgically or endovascular treated patients with ruptured IIA might achieve a better functional outcome in comparison with conservative treatment. However, decision-making process in finding the optimal treatment strategy in this rare clinical setting should be based on an interdisciplinary consensus in each individual patient.