Cerebral infarction, intracerebral hemorrhage, and subarachnoid hemorrhage caused by intracranial aspergillosis: A case report and literature review

This article reports a case of intracranial Aspergillus fumigatus infection following allogeneic hematopoietic stem cell transplantation. Despite antifungal therapy with voriconazole combined with amphotericin B, the patient experienced fulminant disease progression. Dynamic imaging clearly documented the entire process of vascular invasion, from multiple cerebral infarctions and the formation of fungal aneurysms to aneurysm rupture leading to cerebral hemorrhage and subarachnoid hemorrhage. This case highlights the strong angiotropism of intracranial Aspergillus fumigatus and suggests that in immunocompromised patients presenting with rapidly progressive cerebrovascular events accompanied by cranial nerve involvement, high suspicion for this disease and early dynamic vascular imaging evaluation are warranted.