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The Journal of Cardiovascular Surgery 2002 February;43(1):59-62

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Tuberculous pseudoaneurysm of the ascending aorta associated with intracranial tuberculoma

Shigemitsu O., Hadama T., Miyamoto S., Anai H., Sako H.

From the Department of Cardiovascular Surgery Oita Medical University Hasamamachi, Oita, Japan


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A tuber­cu­lous aneu­rysm is ­rare ­and ­fatal ­because it ­may ­lead to a rup­ture ­due to ­the form­ing of a pseu­do­aneu­rysm. A ­lesion is espe­cial­ly uncom­mon in ­the ascend­ing aor­ta. We ­report an unusu­al ­case of tuber­cu­lous pseu­do­aneu­rysm of ­the ascend­ing aor­ta ­which devel­oped 7 ­months ­after ­the ­onset of mul­ti­ple intra­cra­ni­al tuber­cu­lo­ma in a 59-­year-­old ­man. He ­was treat­ed ­for mul­ti­ple intra­cra­ni­al tuber­cu­lo­mas in ­another hos­pi­tal ­because of head­ache ­and ­left homon­y­mous hem­i­ano­pia. The tem­po­ral intra­cra­ni­al tuber­cu­lo­mas ­were ­reduced ­after anti­tu­ber­cu­lous ­drug admin­is­tra­tion. However, ­they ­enlarged ­again short­ly there­af­ter. At ­that ­time, a pseu­do­aneu­rysm of ­the ascend­ing aor­ta ­was ­found, so he ­was intro­duced to ­our depart­ment. Intensive anti­tu­ber­cu­lous ­drugs ­were admin­is­tered per­i­op­er­a­tive­ly ­and post­op­er­a­tive­ly. The intra­cra­ni­al tuber­cu­lo­ma ­was ­reduced pre­op­er­a­tive­ly. After ­that, ­the ascend­ing aor­ta ­was suc­cess­ful­ly ­replaced ­with a Dacron ­graft. A ­hole ­was not­ed in ­the ­back of ­the ascend­ing aor­ta. Three ­years ­after ­the oper­a­tion, no symp­toms of recur­rence ­have ­been rec­og­nized. A tuber­cu­lous pseu­do­aneu­rysm of ­the ascend­ing aor­ta ­may eas­i­ly ­cause system­ic tuber­cu­lo­sis or rup­ture, there­fore it ­should be treat­ed as ear­ly as pos­sible.

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