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Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review

We report a case of unruptured fungal internal carotid artery (ICA) aneurysm and review the pertinent literature. A 79-year-old man presented with decreased visual acuity on the right side, and he was diagnosed with retrobulbar optic neuritis. Medical treatment with steroids resulted in Aspergillus...

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Autores principales: YAMAGUCHI, Junya, KAWABATA, Teppei, MOTOMURA, Ayako, HATANO, Norikazu, SEKI, Yukio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japan Neurosurgical Society 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756250/
https://www.ncbi.nlm.nih.gov/pubmed/26804189
http://dx.doi.org/10.2176/nmc.cr.2015-0206
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author YAMAGUCHI, Junya
KAWABATA, Teppei
MOTOMURA, Ayako
HATANO, Norikazu
SEKI, Yukio
author_facet YAMAGUCHI, Junya
KAWABATA, Teppei
MOTOMURA, Ayako
HATANO, Norikazu
SEKI, Yukio
author_sort YAMAGUCHI, Junya
collection PubMed
description We report a case of unruptured fungal internal carotid artery (ICA) aneurysm and review the pertinent literature. A 79-year-old man presented with decreased visual acuity on the right side, and he was diagnosed with retrobulbar optic neuritis. Medical treatment with steroids resulted in Aspergillus meningoencephalitis spreading to the bottom of bilateral frontal lobes, caused by an intracranial extension of sphenoid sinusitis. Magnetic resonance imaging (MRI) performed 26 days after the start of antifungal therapy showed a denovo right ICA aneurysm projecting anteriorly into the sphenoid sinus. As the aneurysm grew rapidly, it was trapped surgically after establishing a high-flow bypass from the external carotid artery to the middle cerebral artery. The patient’s postoperative course was uneventful. Anti-fungal medication was continued until plasma concentrations of beta-D-glucan decreased to within normal limits. Although fungal ICA aneurysm carries a high mortality rate, early detection and prompt treatment by trapping and high-flow bypass can lead to good clinical outcome.
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spelling pubmed-47562502016-02-18 Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review YAMAGUCHI, Junya KAWABATA, Teppei MOTOMURA, Ayako HATANO, Norikazu SEKI, Yukio Neurol Med Chir (Tokyo) Case Report We report a case of unruptured fungal internal carotid artery (ICA) aneurysm and review the pertinent literature. A 79-year-old man presented with decreased visual acuity on the right side, and he was diagnosed with retrobulbar optic neuritis. Medical treatment with steroids resulted in Aspergillus meningoencephalitis spreading to the bottom of bilateral frontal lobes, caused by an intracranial extension of sphenoid sinusitis. Magnetic resonance imaging (MRI) performed 26 days after the start of antifungal therapy showed a denovo right ICA aneurysm projecting anteriorly into the sphenoid sinus. As the aneurysm grew rapidly, it was trapped surgically after establishing a high-flow bypass from the external carotid artery to the middle cerebral artery. The patient’s postoperative course was uneventful. Anti-fungal medication was continued until plasma concentrations of beta-D-glucan decreased to within normal limits. Although fungal ICA aneurysm carries a high mortality rate, early detection and prompt treatment by trapping and high-flow bypass can lead to good clinical outcome. The Japan Neurosurgical Society 2016-02 2016-01-22 /pmc/articles/PMC4756250/ /pubmed/26804189 http://dx.doi.org/10.2176/nmc.cr.2015-0206 Text en © 2016 The Japan Neurosurgical Society This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Case Report
YAMAGUCHI, Junya
KAWABATA, Teppei
MOTOMURA, Ayako
HATANO, Norikazu
SEKI, Yukio
Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review
title Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review
title_full Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review
title_fullStr Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review
title_full_unstemmed Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review
title_short Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review
title_sort fungal internal carotid artery aneurysm treated by trapping and high-flow bypass: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756250/
https://www.ncbi.nlm.nih.gov/pubmed/26804189
http://dx.doi.org/10.2176/nmc.cr.2015-0206
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