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The management of infectious intracranial aneurysm, either by antibiotics alone or by surgery plus antibiotic therapy, remains controversal. Some authors have recommended initial treatment with antibiotics, plus serial angiography, and consider surgery only in cases where aneurysm enlargement during antibiotic treatment or persistence after treatment is documented Due to the unpredictable rebleeding rate and high morbidity and mortality rate associated with rebleeding, others have argued for prompt surgical intervention. We report a case of surgically treated infectious intracranial aneurysm located distal to the trifurcation of the right middle cerebral artery. During the course. of high-dose antibiotic therapy, rupture and rapid enlargement occurred after the operation, the patient underwent cardiac surgery and is at present in good health.
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