Basilar artery occlusion due to mucormycotic emboli, preceded by acute hydrocephalus

A rare case of brain stem infarction caused by mucormycotic emboli, precede d by acute hydrocephalus, is reported. The patient, who had suffered from l eukemia and had undergone bone marrow transplantation several months before , presented initially with seizure and persistent disturbance of consciousn ess. A head CT scan revealed marked ventricular dilation and diagnosed as a cute hydrocephalus. The patient received emergent ventricular drainage. Des pite the aggressive treatment, the patient did not survive. Autopsy reveale d systemic mucormycosis occluding and invading various arteries including b asilar artery and its branches, causing fatal brainstem infarction. Althoug h early diagnosis remains difficult in the cases of systemic mucormycosis, prompt initiation of treatment is mandatory; one must have in mind the poss ibility of presence of Fungal infection when treating patients with acute n eurological deterioration who have underlying debilitating diseases, even t hough fungi themselves are hard to detect in most cases. (C) 2000 Elsevier Science B.V. All rights reserved.