title: Subarachnoid hemorrhage caused by Aspergillus aneurysm as a complication of transcranial biopsy of an orbital apex lesion--case report.
abstract: A 62-year-old male complaining of unilateral visual disturbance and pain in the involved eye had a small mass at the right orbital apex which was identified as an Aspergillus granuloma by transcranial biopsy. One month later, the patient became comatose because of fatal subarachnoid hemorrhage due to a newly developed aneurysm. Autopsy showed a ruptured aneurysm on the right internal carotid-posterior communicating artery. Histological examination demonstrated prominent Aspergillus invasion of the arterial wall. Aspergillus infection must be taken into consideration in patients with orbital apex syndrome, which may lead to serious cerebrovascular consequences. If sino-orbital lesions are detected by neuroimaging techniques, biopsy using an extradural approach should be performed to obtain a definitive diagnosis.
authors.affiliation: Department of Neurosurgery, Shimane Medical University.
authors.forename: Y
authors.initials: Y
authors.lastname: Okada
authors.forename: T
authors.initials: T
authors.lastname: Shima
authors.forename: M
authors.initials: M
authors.lastname: Nishida
authors.forename: K
authors.initials: K
authors.lastname: Yamane
authors.forename: A
authors.initials: A
authors.lastname: Yoshida
mesh_terms: D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017542:Aneurysm, Ruptured / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D001228:Aspergillosis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D001707:Biopsy, Needle; D002536:Cerebral Arteries / Q000473:pathology; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D008875:Middle Aged; D009915:Orbit / Q000473:pathology; D009916:Orbital Diseases / Q000473:pathology*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery