Intracranial Fungal Granuloma Various Treatment Modalities Depending Upon The Anatomical Structures Involved

Abstract

Objective:  To determine the efficacy and achievement of better results by applying different modalities of management, depending upon the anatomical structures involvement.

Material and Methods:  This is a vast study including 50 cases of intracranial fungal granuloma presenting in the department of Neurosurgery PGMI Lahore General Hospital, Lahore. The study duration was ten year from August 998 to August 2008.

 Prospective and retrospective and observational.

Results:  A total of 50 cases were included in the study. Sex incidence revealed male 30 (60%) and female 20 (40%) patients. The ratio of male to female was 3:2. The age range revealed youngest patient was 10 years of age and oldest patient was 58 years of age. Most of the patients (80%) were in the 3^rd, 4^th, 5^th decade of life.

Conclusion:  I there is intradural extension of the disease then only Bur hole Biopsy should be performed if necessary, otherwise antifungal treatment can be given on clinical basis as well. Attempt to excise the lesion can flare up the disease process, hence should not attempted. If one has performed craniotomy for excision of tumor but per operatively surgeons had the impression of fungal granuloma, fungal stain should be sent immediately to confirm the diagnosis and antifungal should be started immediately. These patients had the tendency to deteriorate on 4^th – 6^th day post operatively, such patient should be subjected for selective hyper-ventilation for one week to 10 days or till the clinical condition of the patient improves significantly.