Fungal sinusitis with cerebral invasion
Patient with recurrent fungal sinusitis underwent previous sinus surgeries and now complains of left proptosis, headache, confusion and disorientation
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Mucoperiosteal thickening seen involving the left frontal, maxillary, ethmoidal and sphenoid sinuses which exhibits intermediate T1 and low T2 signal intensity, avid enhancement after contrast administration and with intraorbital infiltration at the medial side of left orbit and intracranial invasion via the cribriform plate. The left gyrus rectus shows a focal area of abnormal signal surrounded by edema and enhances after contrast administration.
Chronic invasive fungal sinusitis that infiltrates the orbit through lamina papyracea and infiltrates the olfactory gyrus through the cribriform plate. The affected olfactory gyrus shows abnormal signal intensity, abnormal enhancement and surrounded by edema. Biopsy revealed Aspergillus flavus.