Skull Base Clinical Syndromes

  • Jagarlapudi M. K. Murthy
  • Subhendu Parida


Clinical manifestations fungal infections of fungal infections of central nervous system are varied and on occasions give a clue to the possible fungal pathogen. Morphology and size of the fungus determine the pathology and consequently the presenting clinical syndromes. Skull base clinical syndromes are the common presenting features of invasive Aspergillus spp. and Mucorales spp. In countries with temperate climates, skull base clinical syndromes are often the presenting clinical features in patients with sino-cranial Aspergillosis, mostly in immunocompetent individuals.


Skull base syndromes Sino-cranial aspergillosis Chronic meningitis Skull base osteomyelitis 



Central nervous system


Computed tomography


Magnetic resonance imaging


Skull base osteomyelitis


  1. Antinori S, Corbellino M, Meroni L, Resta F, Sollima S, Tonollni M, Tortorano AM, Millazzo L, Bello L, Furfaro E, Galli M, Viscoli C. Aspergillus meningitis: a rare clinical manifestation of central nervous systemic aspergillosis. Case report and review of 92 cases. J Infect. 2013;66:218–38.CrossRefGoogle Scholar
  2. Blyth CC, Games L, Sorrell TC, da Cruz M, Sud A, Chen SCA. Skull-base osteomyelitis: fungal vs. bacterial infection. Clin Microbiol Infect. 2011;17:306–11.CrossRefGoogle Scholar
  3. Johnson AK, Batra PS. Central skull base osteomyelitis: an emerging clinical entity. Laryngoscope. 2014;124:1084–8.Google Scholar
  4. LeClerc N, Verilaud B, Duet M, Gulchard JP, Herman P, Kania R. Skull base osteomyelitis incidence of resistance, morbidity, and treatment strategy. Laryngoscope. 2014;124:2013–6.CrossRefGoogle Scholar
  5. Murthy JMK, Sundaram C, Prasad VS, Purohit AK, Rammurti S, Laxmi V. Aspergillosis of central nervous system: a study of 21 patients seen in a university hospital in south India. J Assoc Physicians India. 2000;48:677–81.PubMedGoogle Scholar
  6. Murthy JMK, Sundaram C, Prasad VS, Purohit AK, Rammurti S, Laxmi V. Sinocranial aspergillosis: a form of central nervous system aspergillosis in south India. Mycoses. 2001;44:141–5.CrossRefGoogle Scholar
  7. Murthy JMK. Fungal infections of the central nervous system: the clinical syndromes. Neurol India. 2007;55:221–5.CrossRefGoogle Scholar
  8. Murthy JMK, Sundaram C. Fungal infections of the central nervous system. In: Biller J, Ferro JM, editors. Handbook clinical neurology. Vol 121 (3rd series); Neurological aspects of systemic disease part III, vol. 121. Amsterdam: Elsevier BV; 2014. p. 1383–401.Google Scholar
  9. Panackal AA, Li H, Kontoyiannis DP, Mori M, Pergo CA, Boeckh M, Marr KA. Geoclimatic influences on invasive Aspergillosis after hematopoietic stem cell transplantation. Clin Infect Dis. 2010;50:1588–97.CrossRefGoogle Scholar
  10. Ridder GJ, Breunig C, Kaminsky J, Pfeiffer J. Central skull base osteomyelitis: new insights and implications for diagnosis and treatment. Eur Arch Otorhinolaryngol. 2015;272:1269–76.CrossRefGoogle Scholar
  11. Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Schaufele RL, Sein M, Sein T, Chu JH, Kontoviannis DP, Walsh TJ. Epidemiology and outcome of zygomycosis: a review of 929 reported case. Clin Infect Dis. 2005;41:634–53.CrossRefGoogle Scholar
  12. Shamim MS, Siddiqui AA, Enam SA, Shah AA, Jooma R, Anwar S. Craniocerebral aspergillosis in immunocompetent hosts: surgical perspective. Neurol India. 2007;55:274–81.CrossRefGoogle Scholar
  13. Shankar SK, Mahadevan A, Sundaram C, Sarkar C, Chacko G, Lanjewar DN, Santosh V, Yasha TC, Radhakrishnan VV. Pathobiology of fungal infections of the central nervous system with special reference to the Indian scenario. Neurol India. 2007;55:198–215.CrossRefGoogle Scholar
  14. Spielmann PM, Yu R, Neeff M. Skull base osteomyelitis current microbiology and management. J Laryngol Otol. 2012;127:S8–S12.CrossRefGoogle Scholar
  15. Stoduslski D, Kawalska B, Stankiewicz C. Otogenic skull base osteomyelitis caused by invasive fungal infection. Eur Arch Otorhinolaryngol. 2006;263:1070–6.CrossRefGoogle Scholar
  16. Sundaram C, Umabala P, Laxmi V, Purohit AK, Prasad VS, Panigrahi M, Sahu BP, Sarathi MV, Kaul S, Borghain R, Meena AK, Jayalakshimi SS, Suvarna S, Mohandas S, Murthy JMK. Pathology of fungal infections of the central nervous system: 17 years’ experience from Southern India. Histopathology. 2006;49:396–405.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jagarlapudi M. K. Murthy
    • 1
  • Subhendu Parida
    • 2
  1. 1.CARE Institute of Neurosciences, CARE HospitalsHyderabadIndia
  2. 2.Neuroradiology, CARE Institute of Neurosciences, CARE HospitalsHyderabadIndia

Personalised recommendations