Ruptured intracranial mycotic aneurysm: a rare cause of intracranial hemorrhage

Abstract

Intracranial mycotic aneurysm is a rare complication in patients with infective endocarditis occurring in about 2% to 10% of cases. Although the risk of rupture is about 1.7%, it is usually a catastrophic event with a fatality rate of 80%. Neurological deficits secondary to cortical involvement are common, given the frequency of intralobar hemorrhage. We report two cases of intracerebral hemorrhage caused by ruptured intracranial mycotic aneurysms. Both had involvement of the right frontoparietal lobes with resultant left hemiparesis, left homonymous hemianopia, and impairments of cognition and perceptual function. Despite intensive rehabilitation, their functional outcomes were less than satisfactory as they needed assistance in self-care activities and mobility on discharge.