Granuloma formation and arterial thrombosis following cotton wrapping of an intracranial aneurysm a case report

Gianetti, Alexandre Varella; Perpetuo, Francisco Otaviano Lima

doi:10.1590/S0004-282X1992000400021

Abstracts

The authors report the case of a patient whose left middle cerebral artery aneurysm was wrapped with cotton. Occlusion of the middle cerebral artery, probably secondary to a foreign-body inflammatory reaction, developed late in the postoperative course. A computerized tomography scan revealed cerebral infarct, and an enhancing expansive lesion at the site of the aneurysm suggesting the formation of a granuloma. These findings are discussed and the literature is reviewed.

intracranial aneurysm wrapping (cotton); foreign-body granuloma; arterial thrombosis

Os autores descrevem o caso de um paciente cujo aneurisma da artéria cerebral média esquerda foi envolvido com algodão. Oclusão da artéria cerebral média, provavelmente devida a reação inflamatória de tipo corpo estranho, desenvolveu-se tardiamente no curso pós-operatório. Tomografia computadorizada revelou infarto cerebral e uma lesão expansiva, que aumentava de densidade após injeção de contraste, no local do aneurisma, sugerindo formação de granuloma. Estes achados são discutidos e a literatura é revista.

envolvimento de aneurisma intracraniano (algodão); granuloma tipo corpo-estranho; trombose arterial

Granuloma formation and arterial thrombosis following cotton wrapping of an intracranial aneurysm a case report

Formação de granuloma e trombose arterial após envolvimento de aneurisma intracraniano com algodão: relato de caso

Alexandre Varella Gianetti^I; Francisco Otaviano Lima Perpetuo^II

^IMédico Residente. Departamento de Psiquiatria e Neurologia da Universidade Federal de Minas Gerais

^IIProfessor Adjunto. Departamento de Psiquiatria e Neurologia da Universidade Federal de Minas Gerais

SUMMARY

The authors report the case of a patient whose left middle cerebral artery aneurysm was wrapped with cotton. Occlusion of the middle cerebral artery, probably secondary to a foreign-body inflammatory reaction, developed late in the postoperative course. A computerized tomography scan revealed cerebral infarct, and an enhancing expansive lesion at the site of the aneurysm suggesting the formation of a granuloma. These findings are discussed and the literature is reviewed.

Key words: intracranial aneurysm wrapping (cotton), foreign-body granuloma, arterial thrombosis.

RESUMO

Os autores descrevem o caso de um paciente cujo aneurisma da artéria cerebral média esquerda foi envolvido com algodão. Oclusão da artéria cerebral média, provavelmente devida a reação inflamatória de tipo corpo estranho, desenvolveu-se tardiamente no curso pós-operatório. Tomografia computadorizada revelou infarto cerebral e uma lesão expansiva, que aumentava de densidade após injeção de contraste, no local do aneurisma, sugerindo formação de granuloma. Estes achados são discutidos e a literatura é revista.

Palavras-chave: envolvimento de aneurisma intracraniano (algodão), granuloma tipo corpo-estranho, trombose arterial.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Dr. Francisco Otaviano Lima Perpetuo Rua Santa Catarina 1313/801 - 30180 Belo Horizonte MG - Brasil.

1. Chambi I, Tasker RR, Gentili F. Gaze-induced granuloma («gauzoma»): an uncommon complication of gaze reinforcement of berry aneurysms. J Neurosurg 1990, 72:163-170.
2. Coe JE, Bondurant CP. Late thrombosis following the use of autogenous fascia and a cyanoacrylate (Eastman 910 Monomer) for the wrapping of an intracranial aneurysm. J Neurosurg 1964, 21:884-886.
3. Dutton J. Acrylic investment of intracranial aneurysms: a report of 12 years' experience. J Neurosurg 1969, 31:652-657.
4. Kempe LG. Aneurysm, anterior part of the circle of Willis. In Kempe LP (ed) : Operative Neurosurgery. Berlin: Springer, 1985, 22-75.
5. Haisa T, Matsumiya K, Yoshimasu N. Foreign body granuloma as a complication of wrapping and coating an intracranial aneurysm: case report. J Neurosurg 1990, 72:202-294,
6. Hayes GJ, Leaver RC. Methyl methacrylate investment of intracranial aneurysms: a report of seven years experience. J Neurosurg 1966, 25:79-80.
7. Mount LA, Antunes L. Results of treatment of intracranial aneurysms by wrapping and coating. J Neurosurg 1975, 42:189-193.
8. Pool JL. Muslin gaure in intracranial vascular surgery: technical note. J. Neurosurg 1976, 44:127-128.
9. Sachs E Jr. The fate of muscle and cotton wrapped about intracranial carotid arteries and aneurysms: a laboratory and clinico-pathological study. Acta Neurochir 1972, 26:121-137.
10. Shimosaka S, Waga S. Foreign-body granuloma simulating recurrence of falx meningioma: case report. J Neurosurg 1983, 50:1085-1087.
11. Sturdy JH, Baird RM, Gerein AN. Surgical sponges: a cause of granuloma and adhesion formation. Ann Surg 1967, 165:128-134.
12. Sugita K. Microsurgical Atlas. Berlin: Springer, 1985.
13. Taylor JC, Choudhury AR. Reinforcement with gauze wrapping for ruptured aneursyms of the middle cerebral artery. J Neurosurg 1977, 47:828-832.

Publication Dates

Publication in this collection
22 Feb 2011
Date of issue
Dec 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Chambi I, Tasker RR, Gentili F. Gaze-induced granuloma («gauzoma»): an uncommon complication of gaze reinforcement of berry aneurysms. J Neurosurg 1990, 72:163-170.

[2] 2. Coe JE, Bondurant CP. Late thrombosis following the use of autogenous fascia and a cyanoacrylate (Eastman 910 Monomer) for the wrapping of an intracranial aneurysm. J Neurosurg 1964, 21:884-886.

[3] 3. Dutton J. Acrylic investment of intracranial aneurysms: a report of 12 years' experience. J Neurosurg 1969, 31:652-657.

[4] 4. Kempe LG. Aneurysm, anterior part of the circle of Willis. In Kempe LP (ed) : Operative Neurosurgery. Berlin: Springer, 1985, 22-75.

[5] 5. Haisa T, Matsumiya K, Yoshimasu N. Foreign body granuloma as a complication of wrapping and coating an intracranial aneurysm: case report. J Neurosurg 1990, 72:202-294,

[6] 6. Hayes GJ, Leaver RC. Methyl methacrylate investment of intracranial aneurysms: a report of seven years experience. J Neurosurg 1966, 25:79-80.

[7] 7. Mount LA, Antunes L. Results of treatment of intracranial aneurysms by wrapping and coating. J Neurosurg 1975, 42:189-193.

[8] 8. Pool JL. Muslin gaure in intracranial vascular surgery: technical note. J. Neurosurg 1976, 44:127-128.

[9] 9. Sachs E Jr. The fate of muscle and cotton wrapped about intracranial carotid arteries and aneurysms: a laboratory and clinico-pathological study. Acta Neurochir 1972, 26:121-137.

[10] 10. Shimosaka S, Waga S. Foreign-body granuloma simulating recurrence of falx meningioma: case report. J Neurosurg 1983, 50:1085-1087.

[11] 11. Sturdy JH, Baird RM, Gerein AN. Surgical sponges: a cause of granuloma and adhesion formation. Ann Surg 1967, 165:128-134.

[12] 12. Sugita K. Microsurgical Atlas. Berlin: Springer, 1985.

[13] 13. Taylor JC, Choudhury AR. Reinforcement with gauze wrapping for ruptured aneursyms of the middle cerebral artery. J Neurosurg 1977, 47:828-832.