J Korean Neurosurg Soc.  2011 Mar;49(3):186-189.

Occlusion of the Internal Carotid Artery due to Intracranial Fungal Infection

• Kim JP
• Park BJ
• Lee MS
• Lim YJ

Abstract

In recent years the immunocompromised population has increased rapidly to include people with acquired immune deficiency syndrome (AIDS), drug abusers, and transplant patients. Accordingly, the incidence of intracranial fungal infection has increased. Our institution experienced 2 cases of internal carotid artery (ICA) occlusion due to invasion of the cavernous sinus by an intracranial fungal infection. The first case was a 60-year-old man who presented with headache, eye pain, conjunctival injection, right-sided diplopia, and blurred vision. Infected tissues within the frontal and ethmoid sinuses were removed via bifrontal craniotomy and endoscopic sinus surgery through the Caldwell Luc approach. The second case was a 63-year-old woman who developed right-sided facial pain after a tooth extraction. The infection was not controlled despite continuous use of antifungal agents, resulting in death from sepsis. We believe that when intracranial fungal infection is suspected in a patient with orbital symptoms and a focal neurologic deficit, immediate angiographic investigation of possible ICA occlusion is warranted. Aggressive treatment with antifungal agents is the only way to improve prognosis.

Keyword

Internal carotid artery occlusion; Fungal infection

MeSH Terms

Acquired Immunodeficiency Syndrome
Antifungal Agents
Carotid Artery, Internal
Cavernous Sinus
Craniotomy
Diplopia
Drug Users
Ethmoid Sinus
Eye Pain
Facial Pain
Female
Headache
Humans
Incidence
Middle Aged
Neurologic Manifestations
Orbit
Prognosis
Sepsis
Tooth Extraction
Transplants
Vision, Ocular
Antifungal Agents