Intracerebral hemorrhage and subarachnoid hemorrhage as a manifestation of ruptured intracranial mycotic aneurysms: A report of 2 cases

Intracranial mycotic aneurysms (IMA) are caused by abnormal dilatation of brain vessels due to infective dissemination, most often associated with endocarditis vegetation. This condition is relatively rare, accounting for approximately 0.7%-5.4% of all intracranial aneurysms. However, the related morbidity and mortality levels are high due to the occurrence of intracranial (ICH) and subarachnoid hemorrhage (SAH). We report 2 cases of intracranial mycotic aneurysms that presented to us with features of ICH and SAH and were managed successfully with endovascular therapy. Presently, there are no standardized recommendations for determining the clinical diagnosis and therapy of intracranial mycotic aneurysms. Hence, the treatment given to patients varies greatly. However, it is crucial to achieve a proper diagnosis and initiate early aggressive therapy to improve the prognosis of patients. Endovascular therapy and surgical techniques are safe and effective options with higher survival rates than single-conservative management.