Clinical case of acute formation and rupture of cerebral aneurysm in a patient with autoimmune encephalitis

Abstract

Cerebral aneurysms can form against the background of infectious and inflammatory processes leading to local inflammation and damage to the cerebral artery wall. In the scientific literature, such aneurysms are called “infectious”, and in most cases, they occur in patients with bacterial endocarditis, while they can develop against the background of any bacterial, viral and fungal infections. They are most often localized on the distal branches of the middle cerebral artery, less often on the posterior and anterior cerebral arteries. Infectious aneurysms can form in a short period of time and most often manifest as rupture with subarachnoid and/or intracerebral hemorrhage.
Material and methods. The article presents a clinical case of a patient with autoimmune encephalitis, complicated by the formation and rupture of a large aneurysm.
Results. The aneurysm formed in less than a month of observation of the patient and was localized in the distal segment of the posterior cerebral artery, which is typical for infectious aneurysms, however, according to the examination data, it was not possible to confirm the infectious nature of encephalitis. X-ray endovascular closure of the aneurysm along with the supporting artery was performed with a satisfactory clinical outcome.
Conclusions. The formation of infectious aneurysms can be rapid, with the most frequent manifestation being subarachnoid hemorrhage. The presence of meningeal symptoms or the detection of cerebral hemorrhage by neuroimaging in patients with infectious and inflammatory processes, first of all, requires special attention to the possible development of infectious aneurysms in the distal areas of the cerebral arteries.