Objective To explore the clinical and imaging features and prognosis of intracranial aspergillosis(ICA).Methods A total of nine patients with ICA in Beijing Friendship Hospital,Capital Medical University from January 2013 to January 2024 were selected,and the clinical manifestations,laboratory examination results,imaging features,treatment plan and clinical prognosis of were analyzed retrospectively.Results Among the nine patients,five were male and four were female,age from 4 to 70 years,with an average age of 40.4 years.The common clinical presentations of ICA were fever,headache,cranial nerve involvement,neurological deficits,and impaired consciousness.Cerebrospinal fluid examination was performed in six patients,with three showing increased cerebrospinal fluid pressure and WBC.Cranial imaging showed that the frequently involved sites were brain parenchyma,cerebrovascular,cavernous sinus,meninges,and pituitary gland.Eight patients received voriconazole treatment,with an average duration of six months.Four patients died during the follow-up until March 2024.Conclusions ICA is often accompanied by cerebrovascular diseases,especially meningeal lesions.ICA lacks specific clinical features,and population with normal immune function are also at risk of being infected with Aspergillus.mNGS is helpful for the early diagnosis of ICA,and early standardized application of voriconazole and other fungal treatments can obviously improve the prognosis of ICA patients.
central nervous system infection(CNS)aspergilluscerebrospinal fluid(CSF)metagenomic next-generation sequencing(mNGS)voriconazole
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