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Journal of Korean Neurosurgical Society > Volume 49(3); 2011 > Article
Journal of Korean Neurosurgical Society 2011;49(3): 186-189.
doi: https://doi.org/10.3340/jkns.2011.49.3.186
Occlusion of the Internal Carotid Artery due to Intracranial Fungal Infection.
Joo Pyung Kim, Bong Jin Park, Mi Suk Lee, Young Jin Lim
1Division of Infectious Diseases, Department of Neurosurgery, Kyung Hee University College of Medicine, Seoul, Korea. hyunsong@khmc.or.kr
2Division of Infectious Diseases, Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
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.
Key Words: Internal carotid artery occlusion; Fungal infection
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