case_images: PMC6443639_01
case_images: Initial CT head demonstrating periorbital edema and inflammation in the ethmoid and maxillary sinuses. There is no evidence of acute intracranial abnormality.
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case_images: F1
case_images: Immediate CT of the head revealed no obvious acute abnormalities (Figure 1); however, CTA head demonstrated occlusion of the cavernous segment of the RICA.
case_images: (Top): AP (left) and lateral (right) digital subtraction angiogram illustrating right ICA terminus occlusion on common carotid injection. (Bottom): AP (left), lateral (right) demonstrating TICI III recanalization after thrombectomy.
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case_images: F2
case_images: Utilizing standard thrombectomy techniques, a TICI III (Thrombolysis in Cerebral Infarction) revascularization was achieved (Figure 2) using a retrievable stent system.
case_images: Diffusion weighted imaging (DWI) sequences demonstrating diffusion restriction in the basal ganglia that is characteristically seen in rhinocerebral mucormycosis.
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case_images: F3
case_images: Post-procedural MRI demonstrated diffusion restriction over the right basal ganglia, middle and inferior frontal lobes, and anterior temporal lobe (Figure 3).
case_images: (Left) Gomori methenamine silver (GMS) stain highlighting fungal wall and the pathognomonic non-septate branching hyphae. (Right) High-power H&E stain demonstrating hyphae and inflammatory cells with limited blood product. Photo Credit: Sin Nguyen, MD.
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case_images: F4
case_images: Final pathology and culture were positive for fungal hyphae consistent with RCM (Figure 4).