Question 1139
{"accessible":false,"alternatives":[{"id":5698,"text":"endovascular approaches may be treatment options"},{"id":5699,"text":"fungal intracranial mycotic aneurysms are typically more peripherally located than bacterial intracranial mycotic aneurysms"},{"id":5700,"text":"they can be asymptomatic until rupture"},{"id":5701,"text":"they can be formed via direct extravascular invasion of arterial walls, such as in leptomeningitis"},{"id":5702,"text":"when bacterial infective endocarditis is implicated, it is usually left-sided"}],"archived":false,"correctAlternativeId":5699,"explanation":"\u003cp\u003e\u003ca href=\"/articles/intracranial-mycotic-aneurysm\"\u003eIntracranial mycotic aneurysms\u003c/a\u003e are a rare form of intracranial aneurysm, typically occurring in the setting of left-sided bacterial \u003ca href=\"/articles/infective-endocarditis\"\u003einfective endocarditis\u003c/a\u003e, although can also be secondary to fungal and viral (very rarely) disease, and also secondary to\u0026nbsp;direct extravascular invasion of arterial walls form local pathologies such as \u003ca href=\"/articles/leptomeningitis\"\u003eleptomeningitis\u003c/a\u003e or \u003ca href=\"/articles/brain-abscess-1\"\u003ebrain abscess\u003c/a\u003e.\u003c/p\u003e\u003cp\u003eAneurysms may be asymptomatic prior to rupture, when they then present with features of \u003ca href=\"/articles/subarachnoid-haemorrhage\"\u003esubarachnoid hemorrhage\u003c/a\u003e or \u003ca href=\"/articles/intracerebral-haemorrhage\"\u003eintracerebral hemorrhage\u003c/a\u003e.\u003c/p\u003e\u003cp\u003eTypically, intracranial aneurysms secondary to bacteremia are located in peripheral branch points of the \u003ca href=\"/articles/middle-cerebral-artery\"\u003emiddle cerebral artery\u003c/a\u003e (M2 and beyond), while those secondary to fungemia are often more proximal involving long segments of intracranial vessels. Intracranial mycotic aneurysms can be evaluated with CT, MRI, or DSA, the latter being the gold-standard imaging modality.\u003c/p\u003e\u003cp\u003eManagement includes antibiotic therapy, and in certain circumstances, surgical therapy with clipping or endovascular approaches (e.g. endovascular coil embolization).\u003c/p\u003e","id":1139,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2319","nextQuestionPath":null,"relatedArticles":[{"id":47375,"title":"Infective endocarditis","link":"/articles/infective-endocarditis?lang=us"},{"id":1706,"title":"Mycotic aneurysm","link":"/articles/mycotic-aneurysm?lang=us"}],"alsoUsedIn":[],"stem":"\u003cp\u003eWhich of the following is\u0026nbsp;\u003cstrong\u003eNOT\u003c/strong\u003e\u0026nbsp;true of intracranial mycotic (or infectious) aneurysms?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/1139"}],"attemptsPercentages":[{"alternativeId":"5700","percentage":8},{"alternativeId":"5699","percentage":45},{"alternativeId":"5701","percentage":5},{"alternativeId":"5702","percentage":22},{"alternativeId":"5698","percentage":20}],"promptToLogin":false,"questionManager":false,"articleId":"intracranial-mycotic-aneurysm"}