Case reportSuccessful coil embolization of a ruptured mycotic aneurysm that developed three days after septic embolic infarction: Case report and review of the literature

•A rare case of rapidly developing infectious intracranial aneurysm is described.•The patient initially presented with ischemic stroke due to septic embolism.•Coil embolization successfully treated the ruptured aneurysm.•The relevant literature is briefly reviewed.

BackgroundInfectious intracranial aneurysms (IIAs) are rare entities and are often associated with septic embolus from infectious endocarditis. They may develop rapidly and carry a higher risk of rupture and mortality compared to noninfectious aneurysms. However, the development and rupture of an IIA within 48 h in a patient with septic infarction patient is exceedingly rare.Case descriptionIn this report, we describe a 25-year-old male who presented with left-sided hemiparesis and dysarthria from septic embolus to the right middle cerebral artery. Thirty-nine hours after presentation, he became encephalopathic following a witnessed seizure. Angiography demonstrated a new, ruptured aneurysm, which was successfully treated with endovascular coil embolization. Our study documents the first report of coil embolization in a rapidly developed infectious aneurysm.ConclusionsImportantly, this case demonstrates that septic infarction may precede and herald IIA development and rupture. If IIA is detected due to rupture, coil embolization can be a safe and effective therapy.