[Cerebral Aspergillosis].

Cerebral aspergillosis is broadly classified into hematogenous dissemination and direct invasion from the paranasal sinuses or orbit. The hematogenous form is characterized by brain abscesses and subcortical infarctions, whereas the direct invasion form typically presents with orbital apex syndrome and cerebral infarctions affecting major vessels. Differentiation from Tolosa-Hunt syndrome, hypertrophic pachymeningitis, brain abscess, and cerebral infarction is essential. The sensitivity of serum β-D-glucan and Aspergillus antigen assays is limited, and inappropriate corticosteroid use may be fatal. When a definitive diagnosis is difficult, empirical antifungal therapy should be considered.