Fungal Internal Carotid Artery Aneurysm Treated by Trapping and High-Flow Bypass: A Case Report and Literature Review
| Autor: | Ayako Motomura, Junya Yamaguchi, Teppei Kawabata, Yukio Seki, Norikazu Hatano |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Carotid Artery Diseases
Male medicine.medical_specialty External carotid artery Case Report trapping Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Aneurysm fungal aneurysm Meningoencephalitis medicine.artery Medicine Aspergillosis Humans 030212 general & internal medicine Sinus (anatomy) Aged high-flow bypass medicine.diagnostic_test business.industry Magnetic resonance imaging Intracranial Aneurysm medicine.disease Magnetic Resonance Imaging Surgery medicine.anatomical_structure Aspergillus Decreased Visual Acuity Middle cerebral artery cardiovascular system Neurology (clinical) Radiology Internal carotid artery business 030217 neurology & neurosurgery Carotid Artery Internal |
| Zdroj: | Neurologia medico-chirurgica |
| ISSN: | 1349-8029 0470-8105 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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