Abstract
Rhinocerebral mucormycosis spreads by contiguous tissue invasion or by vascular spread from the paranasal sinuses. As it breaches the dura and enters the brain, there may be angioinvasion with vascular occlusion and thrombosis, which causes cerebral infarction and tissue hypoxia. Fungal invasion causes a further inflammatory reaction, skull base lesion, intracerebral abscess, or granuloma formation. On imaging, an oedematous sinus mucosa, cellulitis, cerebral ischaemia, and inflammation will appear hypointense on T1-weighted MRI images and hyperintense on T2-weighted images. The paranasal sinus lesions and the intracranial lesions may be hypointense on T1- and T2-weighted images; this is possibly due to the accumulation of haemorrhagic products and paramagnetic materials such as iron, magnesium, and manganese. As the fungus causes angioinvasion, the involved tissues might show the classical contrast cut-off sign.
In this study, the management nuances of cerebral fungal abscess, hydrocephalus, fungal aneurysm, paranasal sinus disease with cavernous sinus involvement, intracranial lesions, extensive extracranial lesions at the skull base, and causes of prolonged morbidity and mortality are discussed. Multi-speciality care, based on an early diagnosis, surgical decompression, and a full course of antifungal therapy aids in fight against the infection and its sequels.
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Manogaran, R. et al. (2022). Cranio-Cerebral Mucormycosis. In: Gupta, N., Honavar, S.G. (eds) Rhino-Orbito-Cerebral Mucormycosis. Springer, Singapore. https://doi.org/10.1007/978-981-16-9729-6_12
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DOI: https://doi.org/10.1007/978-981-16-9729-6_12
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