Invasive intracranial aspergillosis: the management dilemmas.
BACKGROUND
Invasive intracranial aspergillosis remains a disease with high morbidity and mortality. The rapid increase in the incidence of this disease led us to review the literature and formulate a treatment protocol for such patients.


METHODS
An analysis of 46 patients with invasive intracranial aspergillosis is presented and the subgroups of extradural and intradural variety are evaluated with different treatment strategies.


RESULTS
Patients with extradural form of disease had 100% survival, whereas antifungal chemotherapy preloading tends to provide a better outcome.


CONCLUSIONS
Extradural aspergillosis does not need chemotherapy preloading, whereas intradural variant may have improved survival chances after preloading. Liposomal formulation has an advantage of shortened time duration for preloading, because the daily administration dose is 6 times higher than conventional preparation.
Mohindra
Sandeep
S
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. satya_sandee@yahoo.com
Mukherjee
Kanchan Kumar
KK
Chhabra
Rajesh
R
Gupta
Sunil Kumar
SK
Gupta
Rahul
R
Khosla
Virender Kumar
VK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D001927:Brain Diseases / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003399:Craniotomy; D003646:Debridement; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D020953:Neuroaspergillosis / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies
D000935:Antifungal Agents; D000666:Amphotericin B