Ruptured Intracranial Mycotic Aneurysm associated with Acute Subdural Hematoma

Abstract

A case of ruptured intracranial mycotic aneurysm associated with acute subdural hematoma is presented. A 26-year-old woman with cardiac valve disease who had been intermittently febrile for 2 weeks suddenly became comatose. There had been no head injury. At the time of admission, a cardiac murmur was audible and petechiae were noted on the conjunctivae and fingers, suggesting a diagnosis of bacterial endocarditis. The blood culture yielded Streptococcus faecalis. The computed tomographic scan revealed an intracerebral hematoma and acute subdural hematoma. Angiography disclosed an aneurysm at the distal middle cerebral artery. Such a combination of intracranial mycotic aneurysm and acute subdural hematoma is very rare.