MRI Presentation of Infectious Intracranial Aneurysms in Infective Endocarditis

Ibrahim Migdady, Cory J. Rice, Catherine Hassett, Lucy Q. Zhang, Dolora Wisco, Ken Uchino, Sung-Min Cho

Research output: Contribution to journalArticle

Abstract

Background: The radiographic appearance of infectious intracranial aneurysms (IIAs) of infective endocarditis (IE) on magnetic resonance imaging (MRI) of brain is varied. We aimed to describe the IIA-specific MRI features in a series of patients with IIAs. Methods: Records of patients with active IE who had digital subtraction angiography (DSA) at a tertiary medical center from January 2011 to December 2016 were reviewed. MRIs performed prior to IIA treatment were reviewed for findings on susceptibility-weighted imaging (SWI), diffusion-weighted imaging, and T1 with and without contrast. Results: Of the 732 patients with IE, 53 (7%) had IIAs. Of these, 28 patients had an evaluable pre-treatment MRI, in whom 33 IIAs were imaged. MRI to DSA median time was 1 day (interquartile range = 1–5). On MRI, 12 (36%) IIAs had SWI lesion with contrast enhancement, 7 (21%) had cerebral microbleeds, 3 (11%) had sulcal SWI lesion, 2 (6%) IIAs had abscesses, 3 (9%) had intraparenchymal hemorrhage, 3 (9%) had subarachnoid hemorrhage, and 6 (18%) had ischemic stroke at the anatomical locations of IIAs. Four IIAs (12%) had no correlating MRI findings, though those patients had MRI without contrast. Conclusion: The MRI features such as SWI lesion and contrast enhancement were the commonest MRI presentations associated with the presence of IIA.

Original languageEnglish (US)
Pages (from-to)658-665
Number of pages8
JournalNeurocritical care
Volume30
Issue number3
DOIs
StatePublished - Jun 15 2019

Keywords

  • Cerebral angiography
  • Infectious intracranial aneurysms
  • Infective endocarditis
  • MRI

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

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  • Cite this

    Migdady, I., Rice, C. J., Hassett, C., Zhang, L. Q., Wisco, D., Uchino, K., & Cho, S-M. (2019). MRI Presentation of Infectious Intracranial Aneurysms in Infective Endocarditis. Neurocritical care, 30(3), 658-665. https://doi.org/10.1007/s12028-018-0654-1