{
  "abstract": "Introduction Infectious intracranial aneurysms (IIAs) are rare but serious complications of systemic infections, particularly infective endocarditis. These aneurysms are prone to rupture, leading to significant morbidity and mortality. Management strategies lack consensus due to the rarity of the condition and reliance on small case series. This study examines the clinical management of IIAs using data from a large multicenter cohort.Methods A retrospective registry-based cohort study was conducted across 11 tertiary care centers in the USA between 2018 and 2023. Patients with IIAs were identified based on clinical and radiographic criteria. The primary outcome was treatment failure defined as persistence, growth, or rupture of the aneurysm. Secondary outcomes were mortality and the modified Rankin Scale (mRS) score at 90 days and 1 year. Multivariate logistic regressions were used to identify outcome predictors.Results A total of 104 patients with 166 aneurysms were included, with a median age of 43 years. Medical management was successful in 56% of cases, with failure often within 18 days of initiation. Predictors of failure included younger age, larger aneurysm size, and rupture at presentation. Surgical and endovascular interventions achieved higher success rates with better outcomes. At 90 days, 57% of patients achieved functional independence (mRS 0–2), while the mortality rate was 24%.Conclusion This study highlights the limitations of medical management for IIAs and underscores the need for early surgical or endovascular intervention in high-risk patients. Outcome predictors aid clinical decision-making, optimizing patient management. Further research is needed to standardize management guidelines for IIAs.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Ali M Alawieh"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Laurie Dimisko"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Youssef M Zohdy"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Yale University, New Hampshire, Connecticut, USA"
      ],
      "name": "Andrew B Koo"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Hassan Saad"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Bachar El Baba"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Sarah Newman"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Neurosurgery, Grady Memorial Hospital, Atlanta, Georgia, USA"
      ],
      "name": "Jonathan A Grossberg"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Yale University, New Hampshire, Connecticut, USA"
      ],
      "name": "Charles Matouk"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "C Michael Cawley"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA",
        "Neurosurgery, Grady Memorial Hospital, Atlanta, Georgia, USA"
      ],
      "name": "Gustavo Pradilla"
    },
    {
      "affiliations": [
        "Neurosurgery, Children’s Healthcare of Atlanta, Atlanta, Georgia, USA"
      ],
      "name": "Andrew Reisner"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Mayo Clinic Jacksonville, Jacksonville, Florida, USA"
      ],
      "name": "W Christopher Fox"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Mayo Clinic Jacksonville, Jacksonville, Florida, USA"
      ],
      "name": "Carlos Perez-Vega"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Jan-Karl Burkhardt"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Mohamed M Salem"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Pascal Jabbour"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Kareem El Naamani"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA"
      ],
      "name": "Richard F Schmidt"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA"
      ],
      "name": "M Reid Gooch"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Robert M Starke"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Ahmed Abdelsalam"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA"
      ],
      "name": "Victor M Lu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, University of Washington, Seattle, Washington, USA"
      ],
      "name": "Michael Levitt"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Reda M Chalhoub"
    },
    {
      "affiliations": [
        "Department of Neurobiology, Morehouse School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Firas Kobeissy"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA"
      ],
      "name": "Alejandro M Spiotta"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Daniel Barrow"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA"
      ],
      "name": "Brian M Howard"
    }
  ],
  "title": "Outcomes of medical and surgical management in infectious intracranial aneurysms: a multicenter cohort analysis",
  "uid": "ba6ce162-a3ee-5682-8caa-b2ba49746b11"
}