Section Editor: Sandy Cheng-Yu Chen, M.D.
Taipei Medical University Hospital, Taipei, Taiwan
Figure Caption
Rhinocerebral mucormycosis is an acute invasive fungal sinusitis seen in the immunocompromised. Non-enhancing nasal mucosa — “black turbinate sign” (arrow in A) on post-gadolinium T1WI — is felt to be almost pathognomonic of this condition. Angioinvasive hyphae involve the mucosal blood supply, causing local infarction and necrosis. The infection spreads aggressively, with intracranial extension via the orbital apex, cavernous sinus, and cribifrom plate. This may result in cavernous sinus thrombosis (arrows in B and C), cranial nerve palsies, cerebral vessel thrombosis, and infarction. Coma and death can occur within days. Early identification and treatment of mucormycosis is therefore crucial.