Intracranial invasive fungal aneurysm due to Aspergillus sinusitis successfully treated by voriconazole plus internal carotid artery ligation therapy in an aged woman

Mami Takemoto; Yasuyuki Ohta; Koh Tadokoro; Ryo Sasaki; Yoshiaki Takahashi; Kota Sato; Toru Yamashita; Nozomi Hishikawa; Jingwei Shang; Masafumi Hiramatsu; Kenji Sugiu; Tomohito Hishikawa; Isao Date; Koji Abe

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Intracranial invasive fungal aneurysm due to Aspergillus sinusitis successfully treated by voriconazole plus internal carotid artery ligation therapy in an aged woman

Author: Mami Takemoto ¹ ; Yasuyuki Ohta ² ; Koh Tadokoro ² ; Ryo Sasaki ² ; Yoshiaki Takahashi ² ; Kota Sato ² ; Toru Yamashita ² ; Nozomi Hishikawa ² ; Jingwei Shang ³ ; Masafumi Hiramatsu ⁴ ; Kenji Sugiu ⁴ ; Tomohito Hishikawa ⁴ ; Isao Date ⁴ ; Koji Abe ²
Author Information

1. Departments of Neurology Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
2. Departments of NeurologyGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
3. Departments of NeurologyGraduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
4. Departments of Neurosurgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Japan
Publication Type:Journal Article
Keywords: Fungal carotid aneurysm; bladder cancer; Bacillus Calmette–Guérin; less invasive endovascular therapy; antibiotics
From:Neurology Asia 2019;24(4):363-367
CountryMalaysia
Language:English
Abstract: A fungal carotid aneurysm is an infrequently occurring infectious aneurysm that is usually treated by antifungal therapy plus surgical debridement of the infected vessel. We herein report an extremely rare case involving a patient with a medical history of bladder cancer treated by Bacillus Calmette– Guérin (BCG) who developed a fungal aneurysm of the internal carotid artery and thrombosis of the superior ophthalmic vein caused by maxillary Aspergillus sinusitis. The patient was successfully treated by antifungal, anticoagulant, and antiplatelet drugs combined with internal carotid artery ligation therapy. Internal carotid artery fungal aneurysm is associated with a high mortality rate, but the present case suggests that it can be successfully treated by antifungal therapy combined with a less invasive endovascular therapy.
Full text:7.2019.my0092.pdf