[Mycotic aneurysm in endocarditis lenta as the etiology of intraparenchymatous cerebral hemorrhage].

METHODS

A 49-year-old male was admitted for left-side headache and mild speech defect. Clinical examination showed a pansystolic murmur of mitral regurgitation and mild Wernicke aphasia. In laboratory studies ESR and CRP were increased. Computed tomography of brain revealed a left temporoparietal hematoma. Echocardiographic examination demonstrated vegetations and mitral valve perforation. In blood cultures grew alpha-streptococci. Cerebral angiography was performed and a fusiform aneurysm on a distal branch of the left middle cerebral artery was identified. Follow-up angiography showed a total resolution of the aneurysm after 6 weeks of intravenous antibiotics.

CONCLUSIONS

This case demonstrate that patients with intracerebral hematomas associated with infectious endocarditis should be investigated for mycotic intracranial aneurysm.