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Group B contained 9 patients with various illnesses not generally known to be associated with CNS aspergillosis. CNS aspergillosis was diagnosed and treated before death in only 1 patient. Patients in Group A received cytotoxic drugs, often had granulocytopenia, less commonly had focal neurological deficits, and seldom had seizures. Group B patients were not granulocytopenic, received no cytotoxic agents, underwent nontransplant surgery, and more frequently had focal neurological deficits. Eleven of the 17 patients (65%) had focal deficits, most of them hemiparesis. Meningeal signs were rare, but the cerebrospinal fluid was usually abnormal. The principal neuropathological process was <jats:italic>Aspergillus<\/jats:italic> invasion of blood vessels causing hemorrhagic infarction. Focal clinical deficits correlated neuroanatomically with <jats:italic>Aspergillus<\/jats:italic> lesions. In 2 patients, such lesions were detected by <jats:sup>99m<\/jats:sup>Tc\u2010DTPA or cerebral angiography before computed tomographic scanning. The lungs were the usual portal of entry, but isolated CNS lesions occurred in 2 patients. CNS aspergillosis should be considered as a cause of new onset of focal neurological deficits in patients with illnesses that are more diverse than has generally been appreciated.<\/jats:p>","DOI":"10.1002\/ana.410180511","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T17:26:31Z","timestamp":1104600391000},"page":"574-582","source":"Crossref","is-referenced-by-count":198,"title":["Aspergillosis of the central nervous system: Clinicopathological analysis of 17 patients"],"prefix":"10.1002","volume":"18","author":[{"given":"Thomas J.","family":"Walsh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel B.","family":"Hier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louis R.","family":"Caplan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2004,10,7]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1259\/0007-1285-52-616-328"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)90007-X"},{"key":"e_1_2_1_4_2","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1542\/peds.68.1.73","article-title":"Aspergillus endocarditis in children: case report and review of the literature","volume":"68","author":"Barst RJ","year":"1981","journal-title":"Pediatrics"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.32.5.473"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01808927"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410090203"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5998.678"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-198012000-00032"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.25.6.702"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.1700860130"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-77-3-383"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.32.6.623"},{"key":"e_1_2_1_14_2","first-page":"383","article-title":"CT scanning in rhinocerebral mucormycosis and aspergillosis","volume":"140","author":"Centeno RS","year":"1981","journal-title":"Neuroradiology"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.42.1.88"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1975.43.2.0236"},{"key":"e_1_2_1_17_2","first-page":"706","article-title":"Computed axial tomography in intracranial aspergillosis. 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