caa a22 4500 477108105 CHVBK 20180405111601.0 cr unu---uuuuu 170330e19960801xx s 000 0 eng 10.1007/BF01411283 doi (NATIONALLICENCE)springer-10.1007/BF01411283 Cranial and intracranial aspergillosis of sino-nasal origin [Elektronische Daten] Report of Nine Cases [Naim-Ur-Rahman,, A. Jamjoom, S. Al-Hedaithy, Z. Jamjoom, M. Al-Sohaibani, S. Aziz] Summary: This paper is an attempt at defining the most efficacious surgical and antifungal therapy for invasive cranial and intracranial aspergillosis, and is based on experience with nine non-immuno-compromised patients treated and followed-up by the authors between 1983 and 1994; as well as on the summary of previously reported cases and advances in therapy of this condition. Depending on the degree of aspergillar involvement of the cranial base and intracranial structures, a classification, with implications for treatment and prognosis, is also proposed. Two patients had extracranial skull base erosion; whereas relentlessly progressive granulomas, mimicking malignancy, invaded the skull base and intracranial contents in seven cases. Of these seven patients with cranial and intracranial invasion, two died of acute intracranial haemorrhage due to fungal invasion of cerebral blood vessels. In two patients, complete surgical eradication of the disease proved impossible due to cavernous sinus involvement, while residual aspergillomas are still present in orbit and paranasal sinuses (PNS) in a further two patients in spite of multiple surgical procedures and prolonged antifungal chemotherapy (AFC). What appears to be a cure has been effected in one patient only. Multiple therapeutic strategies were used. Biopsy plus systemic AFC was ineffective, surgical drainage and debridement plus systemic AFC resulted in long-term survivals but no cure. Radical surgery in conjunction with systemic and local (intracavitary) AFC should be considered to improve an otherwise poor prognosis. Springer-Verlag, 1996 Antifungal chemotherapy nationallicence invasive aspergillosis nationallicence invasive skull base mycosis nationallicence skull base surgery nationallicence Naim-Ur-Rahman, Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut Jamjoom A. aut Al-Hedaithy S. Department of Microbiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut Jamjoom Z. Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut Al-Sohaibani M. Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut Aziz S. Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut Acta Neurochirurgica Springer-Verlag 138/8(1996-08-01), 944-950 0001-6268 138:8<944 1996 138 701 https://doi.org/10.1007/BF01411283 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01411283 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Naim-Ur-Rahman Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut NATIONALLICENCE 700 1- Jamjoom A. aut NATIONALLICENCE 700 1- Al-Hedaithy S. Department of Microbiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut NATIONALLICENCE 700 1- Jamjoom Z. Division of Neurosurgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut NATIONALLICENCE 700 1- Al-Sohaibani M. Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut NATIONALLICENCE 700 1- Aziz S. Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer-Verlag 138/8(1996-08-01), 944-950 0001-6268 138:8<944 1996 138 701 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer