Craniocerebral aspergillosis in immunocompetent hosts has three patterns of presentation that seem to correlate with clinical outcomes. Intracerebral aspergillosis (Type 1) is associated with the worst clinical outcome. Patients with orbital and cranial base aspergillosis (Type 3) had good recovery. Intracranial extradural aspergillosis (Type 2) remained intermediate on the Glasgow Outcome Scale. Preoperative orally administered itraconazole therapy may improve clinical outcome in patients with intracerebral aspergillosis. Prospective clinical studies are required to make firm clinical therapeutic recommendations.

Craniocerebral Aspergillosis of sinonasal origin has typical MR imaging features. These features include a mass lesion producing hypo-to-iso-intense signals on T1-weighted, extremely low signals (hypo-intense) on T2-weighted images, with bright homogenous enhancement on post-gadolinium T1-weighted imaging. These features in the clinical background may be helpful in early diagnosis and management of Aspergillosis of sino-nasal origin in immunocompetent hosts. Prospective clinical study is required to make firm clinical therapeutic recommendations.

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A postsurgical pseudomeningocoele (PSPM) forms when cerebrospinal fluid extravasates through a dura-arachnoidal tear and becomes encysted within the wound. Patients may become symptomatic with wound swelling, headache and radiculopathy. A uniform method of repairing PSPMs is described which includes separation of the dura from the arachnoid, dural repair under operating microscope control, and the use of overlapped local flaps to reinforce the dura and obliterate the PSPM sac. Four recent cases are presented which were successfully treated using this method.