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Intracranial fungal granuloma
- Source :
- Surgical neurology. 47(5)
- Publication Year :
- 1997
-
Abstract
- BACKGROUND Intracranial fungal granulomas are uncommon and their pathogenesis, clinical picture, and effectiveness of therapy remains unclear. METHODS Thirty-two cases were studied retrospectively in two groups: (1) Rhinocerebral group (22 cases) had a chronic paranasal sinus (PNS) disease with secondary involvement of skull base, cranial nerves, and/or brain. The granulomas were adherent to dura, firm, avascular, and tough, requiring a knife to cut. (2) Primary intracranial group (10 cases) had no detectable PNS lesion at initial presentation. The granulomas were soft, suckable, and contained pus or necrotic material. RESULTS Postoperative and overall mortality were 37.5% and 50%, respectively. Meningoencephalitis was the most common cause of death. Altered sensorium, pus in the granuloma, and/or severe brain edema were poor prognostic factors. All survivors except four have symptomatic residual or recurrent lesions. CONCLUSION Early diagnosis with MRI or stereotactic biopsy, radical surgery, and high dose and chronic suppressive chemotherapy may improve overall results in these cases.
- Subjects :
- Adult
Male
medicine.medical_specialty
Stereotactic biopsy
Adolescent
Lesion
medicine
Humans
Radical surgery
Child
Sinus (anatomy)
Mycosis
Aged
Retrospective Studies
Brain Diseases
Granuloma
medicine.diagnostic_test
business.industry
Cranial nerves
Meningoencephalitis
Middle Aged
medicine.disease
Survival Analysis
Surgery
medicine.anatomical_structure
Treatment Outcome
Mycoses
Female
Neurology (clinical)
medicine.symptom
business
Subjects
Details
- ISSN :
- 00903019
- Volume :
- 47
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Surgical neurology
- Accession number :
- edsair.doi.dedup.....35f6eeda6559a4918ddca9aab61ac9e4