Intracranial Fungal Aneurysms

  • Ali Akhaddar
  • Sylma Diabira


Intracranial fungal aneurysm (IFA) is a true “mycotic aneurysm” which occurs through mycotic infection of the intracranial arterial wall. This disease is among the most serious complications of central nervous system fungal infections with a high morbidity and mortality rate. Aspergillus species, Candida albicans, and Mucor species are the three most common pathogens involved. Clinical presentations cannot be categorized as being typical and may vary widely. However, the most common signs and symptoms of IFA are those related to aneurysm bleeding and their causative origin. Digital subtraction angiography continues to be the gold standard for the diagnosis, although computed tomography angiography and magnetic resonance angiography can be used. Classically, IFAs are larger than bacterial ones and located in major cerebral artery trunks. Treatment is based on administration of antifungal agents in combination with surgical or endovascular procedures according to the character and position of the aneurysm and the clinical condition of the patient. Compared to bacterial intracranial aneurysms, fungal ones lead to a poor outcome because of a mixture of difficulty in making a correct diagnosis, poor favorable response to antifungal drugs, proximal site of the aneurysms, adjacent artery thrombosis, immunocompromised status, serious medical comorbidities, and often a friable arterial wall.


Aspergillosis Cerebrovascular complications Fungal aneurysm Intracranial infectious aneurysm Mycotic aneurysm Stroke Subarachnoid hemorrhage 



Central nervous system


Cerebrospinal fluid


Computed tomography


Internal carotid artery


Intracranial fungal aneurysm


Intracranial infectious aneurysm


Magnetic resonance


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ali Akhaddar
    • 1
  • Sylma Diabira
    • 1
    • 2
  1. 1.Department of Neurosurgery, Avicenne Military Hospital of MarrakechMohammed V University of RabatRabatMorocco
  2. 2.Spine Surgery UnitPrivate Hospital of Saint-GrégoireRennesFrance

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