[Valve replacement in infective endocarditis with mycotic cerebral aneurysm. Report of a case with successful operation].

A 49 year-old woman was hospitalized with headache and left-sided weakness. Computed tomographic scan and carotid angiogram revealed mycotic aneurysms of the bilateral middle cerebral artery with intracranial bleeding. Although all blood cultures were sterile, her physical examination suspected mitral regurgitation due to infective endocarditis and mycotic cerebral aneurysms. Severe congestive heart failure developed immediately after successful clipping for ruptured mycotic aneurysm of the right middle cerebral artery and then mitral valve replacement with prosthetic valve was performed 3 months after craniotomy. At operation, infective endocarditis on the mitral valve was confirmed. Her postoperative course was uneventful and the second craniotomy for aneurysm of the left middle cerebral artery has been planning.