Okada Y, Shima T, Nishida M, Yamane K, Yoshida A
Department of Neurosurgery, Shimane Medical University.
Neurol Med Chir (Tokyo). 1998 Jul;38(7):432-7. doi: 10.2176/nmc.38.432.
A 62-year-old male complaining of unilateral visual disturbance and pain in the involved eye had a small mass at the right orbital apex which was identified as an Aspergillus granuloma by transcranial biopsy. One month later, the patient became comatose because of fatal subarachnoid hemorrhage due to a newly developed aneurysm. Autopsy showed a ruptured aneurysm on the right internal carotid-posterior communicating artery. Histological examination demonstrated prominent Aspergillus invasion of the arterial wall. Aspergillus infection must be taken into consideration in patients with orbital apex syndrome, which may lead to serious cerebrovascular consequences. If sino-orbital lesions are detected by neuroimaging techniques, biopsy using an extradural approach should be performed to obtain a definitive diagnosis.
一名62岁男性，因患侧眼睛出现单侧视力障碍和疼痛前来就诊，经颅活检发现其右眶尖有一个小肿块，诊断为曲霉菌肉芽肿。一个月后，患者因新出现的动脉瘤导致致命性蛛网膜下腔出血而昏迷。尸检显示右颈内动脉-后交通动脉有一个破裂的动脉瘤。组织学检查显示动脉壁有明显的曲霉菌侵袭。对于眶尖综合征患者，必须考虑曲霉菌感染，因为这可能导致严重的脑血管后果。如果通过神经影像学技术检测到鼻窦-眼眶病变，应采用硬膜外入路进行活检以明确诊断。
