Rare Intracranial Fungal Aneurysm Followed by Giant Fungal Pseudotumor

Abstract

Intracranial mycotic aneurysms are extremely uncommon lesions resulting from mostly fungal meningitis or septicemia. The prognosis of intracranial fungal aneurysm is usually poor. We report a rare patient with intracranial mycotic aneurysm followed by the giant fungal space-occupying lesion that originated in the left anterior clinoid process, and invaded the cavernous sinus, sphenoid sinus, left frontal lobe, and temporal lobe. The presumed diagnosis of the lesion was meningioma or invasive pituitary adenoma. Postoperative histopathologic examination identified it as being a fungal pseudotumor. Subsequently, spontaneous subarachnoid hemorrhage, which was caused by the rupture of the right vertebral artery aneurysm, was observed. The authors highlighted the clinical characteristics and fatal outcome of the giant fungal space-occupying lesion in this case. Recognition of spontaneous subarachnoid hemorrhage and fungal aneurysm followed by mycotic pseudotumor was also emphasized.