PMC4697199_01
Coronal T1-weighted magnetic resonance image of the sella showing a pituitary macroadenoma with supra-sellar extension
SNI-6-193-g001.jpg
PMC4697199_01_SNI-6-193-g001.jpg
F1
Magnetic resonance imaging (MRI) brain revealed a sellar-supra-sellar mass [Figure 1].
Axial noncontrast computed tomography scan of head showing subarachnoid hemorrhage with intra-ventricular extension
SNI-6-193-g002.jpg
PMC4697199_01_SNI-6-193-g002.jpg
F2
After 3 weeks of hospital stay, he suddenly became unresponsive and CT scan showed a subarachnoid hemorrhage with intraventricular extension [Figure 2].
Cut section of brain showing extensive subarachnoid hemorrhage and ruptured basilar artery aneurysm
SNI-6-193-g003.jpg
PMC4697199_01_SNI-6-193-g003.jpg
F3
To confirm the cause of death, a limited brain autopsy was performed, which revealed extensive subarachnoid hemorrhage and aneurysmal dilatation and thrombosis of the basilar artery (BA) [Figure 3].
Low power photo micrographs taken through the wall of the basilar artery at the site of aneurysm. (a) H and E staining showing dilated and destroyed arterial wall. (b) Elastic Van Gieson staining is showing the loss of internal elastic lamina on the upper part. (c) Gomorri methenamine silver staining is showing an invasive fungal elements from outer to the inner side in the aneurysmal wall. (d) High power photo micrograph showing numerous filamentary infiltrates with an acute angle branching confirming to the morphology of Aspergillus species
SNI-6-193-g004.jpg
PMC4697199_01_SNI-6-193-g004.jpg
F4
Histopathology of the BA revealed the loss of internal elastic lamina and septate hyphae with an acute angle branching on Grocott's methenamine silver stain, conforming to the morphology of Aspergillus [Figure 4a-d].