Imaging Findings in Intracranial Aspergillosis

Yamada, Kazuo; Shrier, David A.; Rubio, Ana; Yuan, Shan; Zoarski, Gregg H.; Yamada, Takashi; Iwanaga, Soji; Nishimura, Tsunehiko; Numaguchi, Yuji

doi:10.1016/s1076-6332(03)80166-6

Cited by 52 publications

(50 citation statements)

References 18 publications

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“…The patient died 8 h after the second CT study. Autopsy revealed evidence of systemic aspergillosis (courtesy of Dr. K. Yamada, Kyoto Prefectural University of Medicine) additional lesions containing hyphae without an inflammatory reaction in an immunocompromised host; these appear as small, subcortical hyperintense lesions in the subcortical area with no contrast enhancement[14][15][16][17].…”

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confidence: 99%

The central nervous system complications of bone marrow transplantation in children

et al. 2008

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Bone marrow transplantation (BMT) is widely performed for both neoplastic and non-neoplastic disease. Before BMT, patients are prepared with high-dose chemotherapy, frequently associated with total-body radiation, to destroy residual malignant cells and to reduce immunologic resistance. BMT is associated with several central nervous system (CNS) complications secondary to underlying disease, prolonged myelosuppression, and the use of immunosuppressive drugs. These complications include infections, vascular disease, drug-induced neurotoxicity, metabolic disturbance, and post-BMT carcinogenesis. The immune status of children after BMT can be divided into three phases: the pre-engraftment period (days 0-30 after BMT), the post-engraftment period (days 30-100), and the late phase (after day 100). The timing of CNS complications that occur after BMT, as for complications in other organs, can be described with reference to these three phases of immune status. It is essential that radiologists become familiar with the relationships between the immune status of the recipient and the times of onset of these disorders, and with the neuroimaging patterns associated with the various complications. CNS complications can be life-threatening for immunosuppressed children, so accurate diagnosis is important for prompt and appropriate treatment.

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confidence: 99%

The central nervous system complications of bone marrow transplantation in children

et al. 2008

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“…[15] The diagnosis of cerebral aspergillosis is difficult because the inaugural symptoms are mostly non specific comprising of headache, fever, paralysis of cranial nerves, paraesthesias, hemiparesis, mental confusion, and/ or epileptic seizures. [16] The symptoms are usually those of a cerebral mass lesion, although the propensity of the fungus to invade blood vessels may lead to extensive necrosis and sometimes to intracranial bleeding. [1] The diagnosis of fungal infections relies on microscopy, culture and pathologic specific tests.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Aspergillosis on autopsy; masquerading clinically as Brain tumor in a young female

Rana

Kalhan²,

Sangwaiya

et al. 2015

Int J of Biomed & Adv Res

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Cerebral aspergillosis is a rare pathology with fatal outcome. It is mostly a post-mortem diagnosis because the initial symptoms are mostly nonspecific and the existing diagnostic modalities are not sensitive to ensure early and definite diagnosis. The clinical manifestations and disease severity are dictated by the immunologic state of the patient. Cerebral aspergillosis can mimic tuberculous meningitis, pyogenic abscess, or brain tumor. Maxillary sinusitis of dental origin or the lungs are the most common sites of primary aspergillus infection. Infection reaches the brain directly from the nasal sinuses via vascular channels or is blood borne from the lungs and gastrointestinal tract. Dissemination of aspergillus is relatively common, with the central nervous system (CNS) being one of the most frequent sites of Invasive aspergillosis (IA) after the lungs. Aspergillosis should be considered in cases manifesting with acute onset of focal neurologic deficits resulting from a suspected vascular or space occupying lesion especially in immunocompromised hosts. Only a high index of suspicion, an aggressive approach to diagnosis, and rapid vigorous therapy can alter the clinical course in this group of patients.

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“…Cerebral aspergillosis typically presents lesions, granuloma and abscesses, isointense to low signal intensity on T2-weighted images [14,15], that could have areas of high signal on T1-weighted images due to haemorrhage [16]. Haemorrhage is more likely in lesions over 15 mm [17]. Contrast enhancement is visible in less then 50% of lesions [16] and tends to be stronger in immunocompetent hosts [17].…”

Section: Discussionmentioning

confidence: 99%

Lethal subarachnoid bleeding under immunosuppressive therapy due to mycotic arteritis

et al. 2002

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A subarachnoid haemorrhage (SAH) occurred 67 days after cardiac transplantation in a 10-year-old girl with consecutive immunocompromising therapy. Neither digital subtraction angiography (DSA) nor computed tomographic angiography showed signs of intracranial vascular malformations. One month before the lethal SAH occurred, she had developed arterial hypertension and attacks of severe headache with cerebrospinal fluid (CSF) pleocytosis while CT scans showed an infarct of the left thalamus. Pathologic findings established the rare diagnosis of SAH due to aspergillosis-related mycotic arteritis. Imaging characteristics are presented.

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Imaging Findings in Intracranial Aspergillosis

Cited by 52 publications

References 18 publications

The central nervous system complications of bone marrow transplantation in children

The central nervous system complications of bone marrow transplantation in children

Cerebral Aspergillosis on autopsy; masquerading clinically as Brain tumor in a young female

Lethal subarachnoid bleeding under immunosuppressive therapy due to mycotic arteritis

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