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Should one perform a subsequent screening CTA or MRA head for mycotic aneurysm after cardio-embolic strokes in a setting of endocarditis with initial unremarkable CTA or MRA head/neck?

2 Answers
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Neurology · HCA Houston Healthcare
Answered on · Updated on
If the initial CTA is unremarkable and there is no intracranial hemorrhage, I do not routinely obtain follow-up imaging. In my practice, CTA is preferred over MRA due to the lower sensitivity of non-contrast/TOF imaging in detecting small mycotic aneurysms. As mentioned above, CTA may also miss s...

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Neurology · Vanderbilt University Medical Center
Answered on

I would definitely do a CTA, though small mycotic aneurysms or embolic occlusions might be missed, and if there is high suspicion, a cerebral arteriogram might be necessary.

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