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A Case of Cavernous Sinus Aspergillosis Tomomi HASE 1 , Hideharu KURITA 1 , Eiji MATSUMOTO 1 , Hajime KURODA 2 , Masaaki HASHIMOTO 1 , Souji SHINODA 3 1Department of Neurosurgery, International University of Health and Welfare Hospital 2Department of Pathology, International University of Health and Welfare Hospital 3Department of Neurosurgery, Japanese Red Cross Koga Hospital Keyword: cavernous sinus , aspergillosis , extradural temporopolar approach , voriconazole pp.901-906
Published Date 2013/10/10
DOI https://doi.org/10.11477/mf.1436102095
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 We reported a case of cavernous sinus aspergillosis. A 62-year-old man complained of trigeminal neuralgia in the right V1 region. Neurological examination on admission showed ptosis, loss of light reflex and ophthalmoplegia externa in the right side. MRI enhanced with gadolinium demonstrated sphenoid sinusitis and mass lesion in the right cavernous sinus. MRA revealed right internal carotid artery occlusion. An open biopsy using the extradural temporopolar approach was performed. Pus discharge was observed from the cavernous sinus and histological examination showed hypha of Aspergillus. With early voriconazole treatment, the patient had improvement in headache, ptosis and ophthalmoplegia externa. Cavernous sinus aspergillosis is often found after sphenoiditis. It results in invasion to an internal carotid artery and worsens the patient's prognosis by cerebral infarction, so early diagnosis and treatment are important. We should consider aspergillosis as one of the differential diagnoses of a mass in the cavernous sinus. The epidural approach to this lesion was available to obviate aspergillus dissemination into the medullary cavity.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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