Worst Case Scenario

July 18, 2008

While the complete medical journal article (see link below) stresses the fact

that there have only been 15 cases of the exact extreme symptoms, resulting in

death, reported since 1968, it would be a good read for all of us who suffer

from sinus problems. I am constantly astounded at the " non-emergency " attitude

of the postings of our sinus sufferers. Instead of comparing notes on medicines

and home remedies, and other people's experiences, I would suggest, based on

this article, that you ALL stick your head in A CT Scan or MRI machine, FIRST,

before you begin chatting or posting.

To those of you who will read the article, the word " epistaxis " means nosebleed.

Joe

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American Journal of Neuroradiology 22:858-863 (5 2001)

ARTICLE

Mycotic Aneurysm and Cerebral Infarction Resulting from Fungal Sinusitis:

Imaging and Pathologic Correlation W. Hurst,a , Judkinsa ,

Bolgera , Albert Chua and Laurie A. Loevnera

a From the Departments of Radiology (R.W.H., L.A.L.), Pathology (A.J., A.C.),

and Otrorhinolaryngology (W.B.), Hospital of the University of Pennsylvania,

Philadelphia, PA.

Summary: A 73-year-old man was admitted with invasive aspergillus of the

sphenoid sinus. Endoscopic debridement of the sphenoid sinus was complicated by

rupture of a mycotic cavernous carotid artery aneurysm with severe epistaxis.

The aneurysm was closed emergently by endovascular coil placement. Subsequently,

the mycotic aneurysm extended intradurally and caused fatal subarachnoid

hemorrhage.

The radiologic-pathologic data illustrate the mechanism of fungal mycotic

aneurysm formation and growth. This case emphasizes the need for rapid diagnosis

of potential fungal involvement of the central nervous system and suggests the

necessity for aggressive treatment once fungal cerebrovascular involvement is

identified.

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