Khachatryan VA, Kim AV, Samochernykh KA, Sidorin VS, Sokolova TV, Don OA, Ivanov VP. [Granulomatous inflammation in the bed of resected cerebral cavernoma in a child, caused by a hemostatic agent].
ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2015;
79:84-94. [PMID:
26529626 DOI:
10.17116/neiro201579484-94]
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Abstract
OBJECTIVE
The study presents a clinical observation of foreign body granuloma, which is rare productive inflammation, developed on treatment with a hemostatic material upon removal of cerebral cavernoma.
MATERIAL AND METHODS
A 4-year-old boy operated on for left parietal lobe cavernoma was diagnosed with a mass lesion during a follow-up MRI examination 4 months after surgery. The patient was re-operated in connection with suspected abscess formation. The pathological tissue was subjected to the histological and immunohistochemical examination.
RESULTS
Inflammation was accompanied by the formation of foreign body granulomas, and, in some areas, had immune nature with signs of focal destructive vasculitis, delayed maturation of the granulation tissue, and disturbance of the current organization and encapsulation processes. It is worth noting that granulomatous inflammation around a hemostatic material in the brain has no specific features during introscopy and mimics an abscess or tumor recurrence.
CONCLUSION
The use of hemostatic materials upon resection of cerebral cavernous malformations may cause formation of granuloma mimicking disease relapse or abscess in the long term period. To prevent granulomatous inflammation, removal of a hemostatic material, if possible, from the surgical field is recommended when reliable hemostasis is achieved.
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