Intracranial fungal granuloma

Intracranial fungal granulomas are uncommon and their pathogenesis, clinical picture, and effectiveness of therapy remains unclear. Thirty-two cases were studied retrospectively in two groups: (1) Rhinocerebral group (22 cases) had a chronic paranasal sinus (PNS) disease with secondary involvement o...

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Bibliographic Details
Published in:Surgical neurology 1997-05, Vol.47 (5), p.489-497
Main Authors: Sharma, B.S., Khosla, V.K., Kak, V.K., Banerjee, A.K., Vasishtha, R.K., Prasad, K.S.Manjunath, Sharma, S.C., Mathuriya, S.N., Tewari, M.K., Pathak, A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aspergillus
Brain Diseases - microbiology
Brain Diseases - mortality
Brain Diseases - surgery
Child
Female
fungal infection
granuloma
Granuloma - microbiology
Granuloma - mortality
Granuloma - surgery
Humans
Male
Middle Aged
mycoses
Mycoses - mortality
Mycoses - surgery
Retrospective Studies
Survival Analysis
Treatment Outcome
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Summary:Intracranial fungal granulomas are uncommon and their pathogenesis, clinical picture, and effectiveness of therapy remains unclear. Thirty-two cases were studied retrospectively in two groups: (1) Rhinocerebral group (22 cases) had a chronic paranasal sinus (PNS) disease with secondary involvement of skull base, cranial nerves, and/or brain. The granulomas were adherent to dura, firm, avascular, and tough, requiring a knife to cut. (2) Primary intracranial group (10 cases) had no detectable PNS lesion at initial presentation. The granulomas were soft, suckable, and contained pus or necrotic material. Postoperative and overall mortality were 37.5% and 50%, respectively. Meningoencephalitis was the most common cause of death. Altered sensorium, pus in the granuloma, and/or severe brain edema were poor prognostic factors. All survivors except four have symptomatic residual or recurrent lesions. Early diagnosis with MRI or stereotactic biopsy, radical surgery, and high dose and chronic suppressive chemotherapy may improve overall results in these cases.
ISSN:0090-3019
1879-3339
DOI:10.1016/S0090-3019(96)00209-1