Rapid formation and rupture of an infectious basilar artery aneurysm from meningitis following suprasellar region meningioma removal: a case report.
BACKGROUND
Infectious basilar artery (BA) aneurysm has been occasionally reported to be generated from meningitis following transcranial operation. However, infectious BA aneurysm formed by intracranial infection after endoscopic endonasal operation has never been reported.


CASE PRESENTATION
A 53-year-old man who was diagnosed with suprasellar region meningioma received tumor removal via endoscopic endonasal approach. After operation he developed cerebrospinal fluid (CSF) leak and intracranial infection. The patient ultimately recovered from infection after anti-infective therapy, but a large fusiform BA aneurysm was still formed and ruptured in a short time. Interventional and surgical measures were impossible due to the complicated shape and location of aneurysm and state of his endangerment, therefore, conservative anti-infective therapy was adopted as the only feasible method. Unfortunately, the aneurysm did not disappear and the patient finally died from repeating subarachnoid hemorrhage (SAH).


CONCLUSION
Though extremely rare, it was emphasized that infectious aneurysm can be formed at any stage after transnasal surgery, even when the meningitis is cured. Because of the treatment difficulty and poor prognosis, it was recommended that thorough examination should be timely performed for suspicious patient to make correct diagnosis and avoid fatal SAH.
['Wang|Xu|X|', 'Chen|Ge|G|', 'Li|Mingchu|M|', 'Liang|Jiantao|J|', 'Guo|Hongchuan|H|', 'Song|Gang|G|', 'Bao|Yuhai|Y|']
D017542:Aneurysm, Ruptured D000900:Anti-Bacterial Agents D001488:Basilar Artery D004724:Endoscopy D017809:Fatal Outcome D006801:Humans D002532:Intracranial Aneurysm D008297:Male D008577:Meningeal Neoplasms D008579:Meningioma D008581:Meningitis D008875:Middle Aged D057605:Natural Orifice Endoscopic Surgery D011183:Postoperative Complications D019292:Skull Base Neoplasms D013345:Subarachnoid Hemorrhage
Bacterial meningitis Endoscopic transnasal operation Infectious intracranial aneurysms Septic microemboli