{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T15:12:19Z","timestamp":1781968339131,"version":"3.54.5"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"10","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The authors describe a rare case of acute large-vessel occlusion due to an infected thrombus formation that was induced by invasive sphenoid sinus aspergillosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>\n                      An 82-year-old man with a history of immunoglobulin G4\u2013related disease and long-term use of steroids and immunosuppressants was admitted to the authors\u2019 hospital with severe right hemiparesis. Cerebral angiography revealed occlusion of the left internal carotid artery (ICA). He underwent thrombectomy, resulting in successful recanalization. However, severe stenosis was evident in the left ICA cavernous segment. Pathological analysis of the retrieved thrombus identified\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      . Postoperative magnetic resonance imaging revealed sinusitis in the left sphenoid sinus as a possible source of the infection. The patient\u2019s general condition deteriorated during the course of hospitalization due to refractory aspiration pneumonia, and he died 46 days after thrombectomy. Pathological autopsy and histopathological investigation of the left ICA and the left sphenoid sinus showed that\n                      <jats:italic>Aspergillus<\/jats:italic>\n                      had invaded the wall of the left ICA from the adjacent sphenoid sinus. These findings indicate a diagnosis of acute large-vessel occlusion due to infected thrombus formation induced by invasive sphenoid sinus aspergillosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Pathological analysis of a retrieved thrombus appears useful for identifying rare stroke etiologies such as fungal infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case23733","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T12:23:16Z","timestamp":1709554996000},"source":"Crossref","is-referenced-by-count":2,"title":["Acute large-vessel occlusion due to an infected thrombus formation induced by invasive sphenoid sinus aspergillosis: illustrative case"],"prefix":"10.3171","volume":"7","author":[{"given":"Yoshiyasu","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Akamatsu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Iwate Medical University, Yahaba-cho, Iwate, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Ogasawara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Iwate Medical University, Yahaba-cho, Iwate, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshinari","family":"Misaki","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunichi","family":"Sasou","sequence":"additional","affiliation":[{"name":"Pathology, Hachinohe Red-Cross Hospital, Hachinohe, Aomori, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromu","family":"Konno","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniaki","family":"Ogasawara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Iwate Medical University, Yahaba-cho, Iwate, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Stroke.","first-page":"35","article-title":"Classification of subtype of acute ischemic stroke. 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J Stroke Cerebrovasc Dis. 2020;29(6):104759."},{"issue":"8","key":"b3","series-title":"Int J Surg.","first-page":"591","article-title":"Fungal infections of the nervous system: current perspective and controversies in management","volume":"8","author":"Raman Sharma R","year":"2010","unstructured":"Raman Sharma R Fungal infections of the nervous system: current perspective and controversies in management. Int J Surg. 2010;8(8):591\u2013601."},{"issue":"4","key":"b4","series-title":"AJNR Am J Neuroradiol.","first-page":"643","article-title":"A standardized method for measuring intracranial arterial stenosis","volume":"21","author":"Samuels OB","year":"2000","unstructured":"Samuels OB, Joseph GJ, Lynn MJ, Smith HA, Chimowitz MI A standardized method for measuring intracranial arterial stenosis. 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