Mycotic aneurysm and cerebral infarction resulting from fungal sinusitis: imaging and pathologic correlation.
A 73-year-old man was admitted with invasive aspergillus of the sphenoid sinus. Endoscopic debridement of the sphenoid sinus was complicated by rupture of a mycotic cavernous carotid artery aneurysm with severe epistaxis. The aneurysm was closed emergently by endovascular coil placement. Subsequently, the mycotic aneurysm extended intradurally and caused fatal subarachnoid hemorrhage. The radiologic-pathologic data illustrate the mechanism of fungal mycotic aneurysm formation and growth. This case emphasizes the need for rapid diagnosis of potential fungal involvement of the central nervous system and suggests the necessity for aggressive treatment once fungal cerebrovascular involvement is identified.
Hurst
R W
RW
Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Judkins
A
A
Bolger
W
W
Chu
A
A
Loevner
L A
LA
D000368:Aged; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000382:microbiology*; D001228:Aspergillosis / Q000150:complications* / Q000175:diagnosis; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000382:microbiology*; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis / Q000382:microbiology*; D004724:Endoscopy; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000382:microbiology*; D018810:Magnetic Resonance Angiography; D008297:Male; D012852:Sinusitis / Q000175:diagnosis / Q000382:microbiology*; D014057:Tomography, X-Ray Computed