诊断大脑后动脉P4段发生的毛霉菌引起的动脉瘤的困难——一例报告
Difficulty of diagnosing a mucor-induced aneurysm arising in segment P4 of the posterior cerebral artery - A case report.
作者信息
Koiso Takao, Komatsu Yoji, Matsumaru Yuji, Ishikawa Eiichi
机构信息
Department of Neurosurgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan.
Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
出版信息
Surg Neurol Int. 2022 Mar 31;13:111. doi: 10.25259/SNI_1273_2021. eCollection 2022.
BACKGROUND
Identification of causative pathogen for fungal aneurysm is frequently difficult. We reported the case of a fungal aneurysm caused by Mucor arising in segment P4 of the posterior cerebral artery (PCA) detected only by histopathological examination.
CASE DESCRIPTION
A 50-year-old female complained of nausea and vomiting. Computed tomography showed an intracranial hemorrhage in the left occipital lobe and acute hydrocephalus due to intraventricular hemorrhaging. Digital subtraction angiography performed after external drainage showed a cerebral aneurysm in segment P4 of the left PCA. Surgical excision of the aneurysm and end-to-end anastomosis of the PCA were performed. A histopathological examination revealed that the aneurysm had been caused by a Mucor infection.
CONCLUSION
In fungal aneurysm cases, especially those involving Mucor infections, it is difficult to identify the causative fungal infection based on cultures, imaging, and serological tests. Therefore, surgical excision and histopathological diagnosis are important for diagnosing such cases if possible.
背景
真菌性动脉瘤致病病原体的鉴定常常很困难。我们报告了一例由毛霉引起的真菌性动脉瘤病例，该动脉瘤位于大脑后动脉（PCA）P4段，仅通过组织病理学检查才被发现。
病例描述
一名50岁女性出现恶心和呕吐症状。计算机断层扫描显示左枕叶颅内出血以及因脑室内出血导致的急性脑积水。在进行外部引流后进行的数字减影血管造影显示左PCA的P4段有一个脑动脉瘤。对该动脉瘤进行了手术切除，并对PCA进行了端端吻合。组织病理学检查显示该动脉瘤是由毛霉感染引起的。
结论
在真菌性动脉瘤病例中，尤其是那些涉及毛霉感染的病例，很难通过培养、影像学和血清学检查来鉴定致病真菌感染。因此，手术切除和组织病理学诊断对于尽可能诊断此类病例很重要。
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