Infected cerebral hemorrhage by ruptured infectious anterior communicating artery giant aneurysm in a patient with T cell acute lymphoblastic leukemia. Case report.

Although the majority of infectious (bacterial) intracranial aneurysms occur in patients with subacute bacterial endocarditis, septic cerebral embolization and infectious intracranial aneurysm formation can also occur in immunocompromised patients. We report the case of ruptured bacterial aneurysm occurring in a 19 years old man immunocompromised by vigorously treated acute lymphoblastic leukemia. This case confirms very poor prognosis for infectious aneurysms in immunocompromised patient reported in literature, suggesting that a high index of suspicion needs for early diagnosis and that a conservative approach (high dose antibiotic therapy with possible delayed surgery) should be preferred unless intracerebral hemorrhage or abscess with significant mass effect provides a clear indication for operative intervention.