Computerized tomography (CT) localized stereotactic craniotomy for excision of a bacterial intracranial aneurysm

BACKGROUND The treatment of bacterial intracranial aneurysms include long-term antibiotic therapy and surgical clipping or resection, Direct surgical approaches to these aneurysms are often complicated by their peripheral location. METHODS We report the use of a computerized tomography (CT) localized stereotactic craniotomy for the excision of a ruptured peripheral bacterial intracranial aneurysm. RESULTS The Leksell Steiner-Lindquist microsurgical guide, with its fiberoptic helium-neon laser, allowed for rapid isolation of the distal aneurysm with minimal cerebral dissection. Since the inflammatory lesion was well demonstrated on postcontrast CT scan, this modality, rather than angiography, was used for localization. CONCLUSIONS In the future, stereotactic craniotomy may facilitate aggressive surgical therapy for infectious aneurysms previously thought not suitable for direct operative approach.