Invasive forms of aspergillosis of the nervous system are relatively rare and are usually diagnosed in immunocompromised patients. We present the case of a young female patient, treated in the last two months with corticosteroids and antifungal drug for pulmonary aspergillosis, who developed progressive paraparesis. An intramedullary abscess at the C7–D1 level was identified and the lesion was treated with a combination of surgery and antifungal therapy. Histopathologic findings of surgical specimens showed myelomalacia with Aspergillus hyphae and a peripheral rim of neutrophils. We consider that the use of multiple drugs and corticosteroids for our patient’s initial community pneumonia could be the factor that transformed her into a mildly immunocompromised individual and permitted the Aspergillus spp. to disseminate through the blood and into the spinal cord. Moreover, we highlight the fact that more attention should be paid to living and working conditions of the patients, as a simple colonization of the lung with Aspergillus spp. could develop, in a short time, into an invasive disease with a high risk of mortality.

Blunt carotid artery injury is a relatively rare but potentially lethal injury that predominantly occurs in high-impact mechanisms such as motor-vehicle collision. Any simptoms or neurological deficits following a multiple trauma patient mandates a thorough evaluation and consideration of BCI. This is a case report on two young patients with neurologic simptoms developed after blunt trauma in the cervical region. Both patients had left internal carotid artery dissection diagnosed on a CT-angiography, followed by middle cerebral artery territory infarction. Although it can be a delayed onset with no signs of vascular demage, we believe that, by implementing a protocol with additional imaging for early detection, we can prevent a devastating outcome.

Introduction. The aneurysmal bone cyst is a benign bone tumor with a low incidence. Its presence within the bone of the hand is quite unusual. When it comes to its evolution, it is known to be an aggressive tumor with a progressive weakening of the bone structure. Objective. This case report aimed to present the importance of keeping the hand function intact for patients who are usually in their first decades of life. As a reconstruction method, a radical surgical approach and grafting are both mandatory for the unit to have the mobility unaltered. Material and methods. It is a case of a 15-year-old male with a giant aneurysmal bone cyst of the fifth metacarpal bone of the left hand. This tumor was surgically removed and the entire bone was rebuilt with an autologous bone graft from the iliac crest. The articular surface was preserved for the distal joint (the head of the metacarpal bone was spared). Results. The surgical procedure concluding the resection and immediate grafting reestablished the function of the hand with no infirmity, and the results for the past 7 years after surgery kept being negative for relapse and the patient had great mobility within the segment. Conclusions: The proper and correct surgical treatment of giant aneurysmal bone cyst located on the fifth metacarpal bone is the mandatory resection of the entire tumor for the high risk of pathological bone fracture with a severe impact on the mobility of the hand.

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