Takahashi Y, Shigemori M, Tokunaga T, Ochiai S, Kuboyama M, Kuramoto S
Department of Neurosurgery, Kurume University School of Medicine, Japan.
No Shinkei Geka. 1991 Jul;19(7):665-9.
Intracranial mycotic aneurysm of extravascular origin is reported. A 64 year-old male developed headache and visual disturbance. Computed Tomography (CT) revealed high density mass lesion with contrast enhancement in the intra- and suprasellar lesion. He was then admitted to our hospital under the diagnosis of pituitary adenoma. But he suddenly complained of headache and loss of vision during hospitalization. An emergency operation using the transsphenoidal approach was performed. The pathological diagnosis was craniopharyngioma. Postoperative radiation therapy was carried out using a tumor dose of 50Gy. Two months after the operation, he suffered from rhinorrhea and high fever. He was admitted again and treated with high doses of antibiotics. Two weeks after admission, he suddenly lost consciousness. A CT scan revealed an aneurysm of the anterior temporal artery. Immediately, removal of the hematoma and resection of the aneurysm were performed. Microscopic examination showed that inflammatory cells had infiltrated the aneurysmal wall, and lymphocytes and plasma cells had gathered around the microabscess. This rare case is discussed with other related cases in the literature.
报告了一例血管外起源的颅内真菌性动脉瘤。一名64岁男性出现头痛和视觉障碍。计算机断层扫描（CT）显示鞍内和鞍上病变有高密度肿块，伴有对比增强。他随后以垂体腺瘤的诊断被收治入院。但住院期间他突然抱怨头痛和视力丧失。采用经蝶窦入路进行了急诊手术。病理诊断为颅咽管瘤。术后采用50Gy的肿瘤剂量进行放射治疗。术后两个月，他出现鼻漏和高热。他再次入院并接受大剂量抗生素治疗。入院两周后，他突然失去意识。CT扫描显示颞前动脉有一个动脉瘤。立即进行了血肿清除和动脉瘤切除术。显微镜检查显示炎性细胞浸润了动脉瘤壁，淋巴细胞和浆细胞聚集在微脓肿周围。本文结合文献中的其他相关病例对这一罕见病例进行了讨论。
