Internal Carotid Artery Bleed: A Rare Complication Of Invasive Sphenoidal Aspergillosis.
World Neurosurg. 2019 Jun 13;:
Authors: Jain A, Goyal K, Meher R, Passey JC
INTRODUCTION: Invasive sinonasal aspergillosis is rarely seen in immunocompetent individuals. It may involve adjacent intracranial and intraorbital structures causing high morbidity and mortality.
CASE REPORT: We report a rare case of invasive aspergillus sinusitis in a young, immunocompetent female causing headache and vision loss. Endoscopic debridement under general anaesthesia was complicated by rupture of mycotic cavernous carotid artery aneurysm. This was managed by packing with muscle and fascia followed by endovascular coiling. Subsequently, the aneurysm extended intradurally and caused fatal subarachnoid haemorrhage.
CONCLUSION: This case emphasizes the need for early diagnosis of invasive fungal sinusitis to prevent intracranial complications and fatal outcome. Once diagnosed, it requires aggressive treatment with surgical debridement and adjuvant antifungal therapy. Internal carotid artery involvement is a rare but life threatening complication of invasive fungal sinusitis.
PMID: 31203084 [PubMed – as supplied by publisher]