Abstract 246: Dynamic nature of Cerebral Mycotic Aneurysm: Two case reports

Cerebral mycotic aneurysms (CMAs) are intracranial aneurysms caused by infectious localized dilatation of intracranial arteries. They compose 0.7‐ 5.5% of intracranial aneurysms, clinically recognized in 3‐10 % of patients with infective endocarditis (IE). Mortality rates vary from 30% in unruptured CMAs to 80% in ruptured CMAs. The clinical presentation ranges from nonspecific constitutional symptoms in unruptured aneurysms to focal neurological deficits in ruptured aneurysms. Digital subtraction angiography (DSA) is the gold standard for CMA diagnosis. Computed tomography with angiography (CTA) and magnetic resonance angiography (MRA) can miss aneurysms <3‐5 mm. Conservative treatment with antibiotics is suitable for unruptured aneurysms. Interventional treatments include surgical clipping and endovascular embolization. Here, we present two cases with CMAs that showed increase in size or detection of new aneurysms on a follow up DSA.