Mycotic aneurysm and cerebral infarction resulting from fungal sinusitis: Imaging and pathologic correlation

A 73-year-old mail was admitted with invasive aspergillus of the sphenoid s inus, Endoscopic debridement of the sphenoid sinus was complicated by ruptu re of a mycotic cavernous carotid artery aneurysm with severe epistaxis. Th e aneurysm was closed emergently by endovascular coil placement. Subsequent ly, the mycotic aneurysm es:tended intradurally and caused fatal subarachno id hemorrhage. The radiologic-pathologic data illustrate the mechanism of fungal mycotic a neurysm formation and growth. This case emphasizes the need for rapid diagn osis of potential fungal involvement of the central nervous system and sugg ests the necessity for aggressive treatment once fungal cerebrovascular inv olvement is identified.