title: Progressive intracranial hypertension and cerebral hypoperfusion in a fatal case of cerebral aspergilloma.
abstract: We report a case of cerebral aspergilloma in a 25-year-old immunoincompetent man admitted to a general intensive care unit. Monitoring of intracranial pressure was instigated and revealed hour-long epochs of severe intracranial hypertension, despite a normal opening pressure, with decreases in cerebral perfusion pressure. We documented that this was associated with cerebral hypoperfusion by transcranial Doppler ultrasound. The present case illustrates that severe intracranial hypertension may evolve despite a normal opening pressure; it furthermore shows that continuous monitoring of intracranial pressure may be used to predict changes in cerebral haemodynamics in critically ill patients with neuroinfection.
authors.affiliation: Centre of Inflammation and Metabolism, University Hospital of Copenhagen, Copenhagen Ø, Denmark.
authors.forename: Linea Natalie
authors.initials: LN
authors.lastname: Toksvang
authors.affiliation: Department of Intensive Care, University Hospital of Copenhagen, Copenhagen Ø, Denmark.
authors.forename: Ronni R
authors.initials: RR
authors.lastname: Plovsing
authors.affiliation: Centre of Inflammation and Metabolism, University Hospital of Copenhagen, Copenhagen Ø, Denmark.
authors.forename: Ronan M G
authors.initials: RM
authors.lastname: Berg
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D002560:Cerebrovascular Circulation; D017809:Fatal Outcome; D006801:Humans; D016867:Immunocompromised Host; D019586:Intracranial Hypertension / Q000175:diagnosis* / Q000209:etiology; D015461:Leukemia, Prolymphocytic, T-Cell / Q000276:immunology*; D008297:Male; D008991:Monitoring, Physiologic; D008271:Mycetoma / Q000150:complications / Q000276:immunology*; D020953:Neuroaspergillosis / Q000150:complications / Q000276:immunology*; D017585:Ultrasonography, Doppler, Transcranial