{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,28]],"date-time":"2025-06-28T04:04:53Z","timestamp":1751083493340,"version":"3.41.0"},"reference-count":18,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nCerebral aspergillosis (CA) is a rare fungal infection and life-threatening disease often associated with immunocompromised patients but can occasionally be present in immunocompetent individuals, mimicking an intracranial neoplasm. CA is highly linked to reduced immunity and is commonly seen in patients with background immunodeficiency, such as acquired immunodeficiency syndrome, chemotherapy, organ transplant patients on immunosuppressive therapy, and those with long-term steroid use. Diagnosis and management of CA can be quite challenging in immunocompetent individuals due to its unusual presentation, non-specific symptoms, and resemblance to tumors in imaging, the necessity of invasive procedures for diagnosis confirmation, complex surgical management, and the need for prolonged antifungal treatment with possible side effects.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nThe case of a 36-year-old immunocompetent male who presented with a 2-year history of recurrent headaches, vomiting, seizures, inability to walk, and altered sensorium, with no history of immunosuppression. Clinical examination revealed a chronically ill patient with multiple cranial nerve palsies, and magnetic resonance imaging revealed a fourth ventricular mass with pan ventriculomegaly causing obstructive hydrocephalus. Initial management of the patient included a ventriculoperitoneal shunt followed by a midline suboccipital craniectomy and excision of the mass lesion 5 days later. Histopathology confirmed CA diagnosis, and the patient was treated with intravenous voriconazole, after which improvement in his clinical status was observed.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nThis case emphasizes the importance of early detection of unusual CA in immunocompetent individuals and the importance of combining surgical intervention with antifungal therapy. The patient presented with a rare form of CA as an intracranial mass causing obstructive hydrocephalus, which initially mimicked a tumor. Early diagnosis and effective management, including surgery and antifungal treatment with voriconazole, led to significant improvement despite incomplete mass removal. Multidisciplinary care and long-term monitoring are crucial for managing such complex cases.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_997_2024","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T09:39:49Z","timestamp":1751017189000},"page":"258","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A rare cause of obstructive hydrocephalus: Cerebral aspergillosis presenting as an intracranial space-occupying lesion in an immunocompetent adult"],"prefix":"10.25259","volume":"16","author":[{"given":"Festus Ayobami","family":"Oshunpidan","sequence":"first","affiliation":[{"name":"Department of Surgery, Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie Nkechi","family":"Martins","sequence":"additional","affiliation":[{"name":"Dukes Neurosurgery and Specialist Hospital, Ikeja, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olalekan Sherif","family":"Adebiyi","sequence":"additional","affiliation":[{"name":"Dukes Neurosurgery and Specialist Hospital, Ikeja, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adekunbi Omowumi","family":"Oshunpidan","sequence":"additional","affiliation":[{"name":"Dukes Neurosurgery and Specialist Hospital, Ikeja, Nigeria"},{"name":"Department of Anaesthesia, Lagos State University Teaching Hospital, Ikeja, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oluwatobi David","family":"Kunle-Ajagbe","sequence":"additional","affiliation":[{"name":"Dukes Neurosurgery and Specialist Hospital, Ikeja, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James Ayokunle","family":"Balogun","sequence":"additional","affiliation":[{"name":"Department of Neurological Suregry, University College Hospital, Ibadan, Nigeria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"10.25259\/SNI_997_2024\/ref-1","doi-asserted-by":"crossref","first-page":"1147871","DOI":"10.3389\/fimmu.2023.1147871","article-title":"Emerging viral infections in immunocompromised patients: A great challenge to better define the role of immune response","volume":"14","author":"Agrati","year":"2023","journal-title":"Front Immunol"},{"key":"10.25259\/SNI_997_2024\/ref-2","first-page":"452","article-title":"Surgical treatment alone of cerebral aspergillosis in immunocompetent patient","volume":"77","author":"Beraldo","year":"2016","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"key":"10.25259\/SNI_997_2024\/ref-3","doi-asserted-by":"crossref","first-page":"e325","DOI":"10.1016\/j.wneu.2013.09.037","article-title":"Isolated cerebral aspergillosis in immunocompetent patients","volume":"82","author":"Bokhari","year":"2014","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_997_2024\/ref-4","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.mmcr.2019.07.011","article-title":"Cerebral aspergillosis presenting as a space occupying lesion in an immunocompetent individual","volume":"25","author":"El Hasbani","year":"2019","journal-title":"Med Mycol Case Rep"},{"key":"10.25259\/SNI_997_2024\/ref-5","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3109\/02688697.2016.1139046","article-title":"Management of granulomatous cerebral aspergillosis in immunocompetent adult patients: A review","volume":"30","author":"Ellenbogen","year":"2016","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_997_2024\/ref-6","first-page":"63","article-title":"Central nervous system aspergillosis: A case report and literature review","volume":"35","author":"Fasciano","year":"1999","journal-title":"Hosp Phys"},{"key":"10.25259\/SNI_997_2024\/ref-7","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1177\/1941874420929191","article-title":"MR target sign in cerebral aspergillosis","volume":"10","author":"Finelli","year":"2020","journal-title":"Neurohospitalist"},{"key":"10.25259\/SNI_997_2024\/ref-8","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.mpdhp.2022.08.009","article-title":"Brain infections that mimic malignancy","volume":"28","author":"Godkhindi","year":"2022","journal-title":"Diagn Histopathol"},{"key":"10.25259\/SNI_997_2024\/ref-9","doi-asserted-by":"crossref","first-page":"101002","DOI":"10.1016\/j.mycmed.2020.101002","article-title":"Invasive rhino-orbital-cerebral aspergillosis in an immunocompetent patient","volume":"30","author":"Leroy","year":"2020","journal-title":"J Mycol Med"},{"key":"10.25259\/SNI_997_2024\/ref-10","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/978-981-16-4047-6_12","article-title":"Aspergillosis","volume-title":"Granulomatous diseases in otorhinolaryngology, head neck","author":"Nemade","year":"2021"},{"key":"10.25259\/SNI_997_2024\/ref-11","doi-asserted-by":"crossref","first-page":"269","DOI":"10.4103\/ijabmr.IJABMR_393_17","article-title":"Cerebral aspergillosis mimicking a neoplasm in an immunocompetent patient","volume":"8","author":"Neyaz","year":"2018","journal-title":"Int J Appl Basic Med Res"},{"key":"10.25259\/SNI_997_2024\/ref-12","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1080\/10428194.2020.1728749","article-title":"Ibrutinib related cerebral aspergillosis successfully treated with isavuconazole: A case report","volume":"61","author":"Nyga","year":"2020","journal-title":"Leuk Lymphoma"},{"key":"10.25259\/SNI_997_2024\/ref-13","doi-asserted-by":"crossref","first-page":"659","DOI":"10.2165\/00023210-200721080-00004","article-title":"CNS aspergillosis: Recognition, diagnosis and management","volume":"21","author":"Ruhnke","year":"2007","journal-title":"CNS Drugs"},{"key":"10.25259\/SNI_997_2024\/ref-14","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s12941-021-00452-9","article-title":"Aspergillosis of central nervous system in patients with leukemia and stem cell transplantation: A systematic review of case reports","volume":"20","author":"Shariati","year":"2021","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"10.25259\/SNI_997_2024\/ref-15","doi-asserted-by":"crossref","first-page":"339","DOI":"10.3109\/00207454.2016.1155573","article-title":"Cerebral aspergillosis: A retrospective analysis of eight cases","volume":"127","author":"Wang","year":"2017","journal-title":"Int J Neurosci"},{"key":"10.25259\/SNI_997_2024\/ref-16","doi-asserted-by":"crossref","first-page":"3942","DOI":"10.12998\/wjcc.v8.i18.3942","article-title":"From infections to autoimmunity: Diagnostic challenges in common variable immunodeficiency","volume":"8","author":"Wi\u0119sik-Szewczyk","year":"2020","journal-title":"World J Clin Cases"},{"key":"10.25259\/SNI_997_2024\/ref-17","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S1413-8670(12)70305-7","article-title":"Invasive intracranial aspergillosis spread by the pterygopalatine fossa in an immunocompetent patient","volume":"16","author":"Xiao","year":"2012","journal-title":"Braz J Infect Dis"},{"key":"10.25259\/SNI_997_2024\/ref-18","doi-asserted-by":"crossref","first-page":"e8908","DOI":"10.1097\/MD.0000000000008908","article-title":"Isolated cerebral aspergillosis in an immunocompetent woman on treatment for bacterial infected necrotizing pancreatitis: A case report","volume":"96","author":"Zhang","year":"2017","journal-title":"Medicine (Baltimore)"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/a-rare-cause-of-obstructive-hydrocephalus-cerebral-aspergillosis-presenting-as-an-intracranial-space-occupying-lesion-in-an-immunocompetent-adult\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-rare-cause-of-obstructive-hydrocephalus-cerebral-aspergillosis-presenting-as-an-intracranial-space-occupying-lesion-in-an-immunocompetent-adult\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T09:39:52Z","timestamp":1751017192000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/a-rare-cause-of-obstructive-hydrocephalus-cerebral-aspergillosis-presenting-as-an-intracranial-space-occupying-lesion-in-an-immunocompetent-adult\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,27]]},"references-count":18,"alternative-id":["10.25259\/SNI_997_2024"],"URL":"https:\/\/doi.org\/10.25259\/sni_997_2024","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2025,6,27]]},"article-number":"258"}}