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Cerebral mucormycosis: neuroimaging findings and histopathological correlation

dc.rights.licenseopenen_US
dc.contributor.authorLERSY, F.
dc.contributor.authorROYER-LEBLOND, J.
dc.contributor.authorLHERMITTE, B.
dc.contributor.authorCHAMMAS, A.
dc.contributor.authorSCHNEIDER, F.
dc.contributor.authorHANSMANN, Y.
dc.contributor.authorLEFEBVRE, N.
dc.contributor.authorDENIS, J.
dc.contributor.authorSABOU, M.
dc.contributor.authorLAFITTE, F.
dc.contributor.authorCOTTON, F.
dc.contributor.authorBONCOEUR-MARTEL, M.-P.
hal.structure.identifierNeurocentre Magendie : Physiopathologie de la Plasticité Neuronale [U1215 Inserm - UB]
dc.contributor.authorTOURDIAS, Thomas
dc.contributor.authorPRUVO, J.-P.
dc.contributor.authorCOTTIER, J.-P.
dc.contributor.authorHERBRECHT, R.
dc.contributor.authorKREMER, S.
dc.date.accessioned2022-03-31T14:53:58Z
dc.date.available2022-03-31T14:53:58Z
dc.date.issued2022-03
dc.identifier.issn1434-1459 (online) 0340-5354 (print)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/136584
dc.description.abstractEnIntroduction : Mucormycosis are infections caused by molds of the order Mucorales. These opportunistic infections are rare, difficult to diagnose, and have a poor prognosis. We aimed to describe common radiographic patterns that may help to diagnose cerebral mucormycosis and search for histopathological correlations with imaging data. Methods : We studied the radiological findings (CT and MRI) of 18 patients with cerebral mucormycosis and four patients’ histopathological findings. Results : All patients were immunocompromised and/or diabetic. The type of lesions depended on the infection’s dissemination pathway. Hematogenous dissemination lesions were most frequently abscesses (59 lesions), cortical, cortical–subcortical, or in the basal ganglia, with a halo aspect on DWI for lesions larger than 1.6 cm. Only seven lesions were enhanced after contrast injection, with different presentations depending on patients’ immune status. Ischemia and hemorrhagic areas were also seen. Vascular lesions were represented by stenosis and thrombosis. Direct posterior extension lesions were bi-fronto basal hypodensities on CT and restricted diffusion without enhancement on MRI. A particular extension, perineural spread, was seen along the trigeminal nerve. Histopathological analysis found endovascular lesions with destruction of vessel walls by Mucorales, microbleeds around vessels, as well as acute and chronic inflammation. Conclusions : MRI is the critical exam for cerebral mucormycosis. Weak ring enhancement and reduced halo diffusion suggest the diagnosis of fungal infections. Involvement of the frontal lobes should raise suspicion of mucormycosis (along with aspergillosis). The perineural spread can be considered a more specific extension pathway of mucormycosis.
dc.language.isoENen_US
dc.subject.enCerebral mucormycosis
dc.subject.enFungal
dc.subject.enInvasive fungal infections
dc.subject.enMRI
dc.subject.enMucormycosis
dc.title.enCerebral mucormycosis: neuroimaging findings and histopathological correlation
dc.title.alternativeJ Neurolen_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1007/s00415-021-10701-8en_US
dc.subject.halSciences du Vivant [q-bio]/Neurosciences [q-bio.NC]en_US
dc.identifier.pubmed34240320en_US
bordeaux.journalJournal of Neurologyen_US
bordeaux.page1386-1395en_US
bordeaux.volume269en_US
bordeaux.hal.laboratoriesNeurocentre Magendie - UMR-S 1215en_US
bordeaux.issue3en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal%20of%20Neurology&rft.date=2022-03&rft.volume=269&rft.issue=3&rft.spage=1386-1395&rft.epage=1386-1395&rft.eissn=1434-1459%20(online)%200340-5354%20(print)&rft.issn=1434-1459%20(online)%200340-5354%20(print)&rft.au=LERSY,%20F.&ROYER-LEBLOND,%20J.&LHERMITTE,%20B.&CHAMMAS,%20A.&SCHNEIDER,%20F.&rft.genre=article


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