Granuloma formation and occlusion of an unruptured aneurysm after wrapping
Excessive granulomatous foreign-body reaction is a very rare complication after wrapping of intracranial aneurysms. The pathogenetic mechanisms underlying this process are unknown. We report on a patient who developed a space-occupying granulomatous abscess after wrapping of an unruptured aneurysm o...
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| Veröffentlicht in: | Acta neurochirurgica 2007-09, Vol.149 (9), p.953-958 |
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| creator | Andres, R H Guzman, R Weis, J Schroth, G Barth, A |
| description | Excessive granulomatous foreign-body reaction is a very rare complication after wrapping of intracranial aneurysms. The pathogenetic mechanisms underlying this process are unknown. We report on a patient who developed a space-occupying granulomatous abscess after wrapping of an unruptured aneurysm of the M2/M3 bifurcation. The patient underwent revision craniotomy for abscess removal. The aneurysm was explored and found to be completely thrombosed and excluded from the circulation. Exuberant granulomatous foreign-body reaction was pathologically confirmed and Candida parapsilosis was isolated from the pus. The patient underwent an antifungal treatment regimen and recovered with no residual neurological deficits. Our findings support the assumption that a low-grade infectious process might trigger excessive inflammatory reaction after wrapping. We suggest that this process may also result in complete thrombosis of cerebral aneurysms, which is otherwise a rarely observed phenomenon. |
| doi_str_mv | 10.1007/s00701-007-1260-8 |
| format | Article |
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The pathogenetic mechanisms underlying this process are unknown. We report on a patient who developed a space-occupying granulomatous abscess after wrapping of an unruptured aneurysm of the M2/M3 bifurcation. The patient underwent revision craniotomy for abscess removal. The aneurysm was explored and found to be completely thrombosed and excluded from the circulation. Exuberant granulomatous foreign-body reaction was pathologically confirmed and Candida parapsilosis was isolated from the pus. The patient underwent an antifungal treatment regimen and recovered with no residual neurological deficits. Our findings support the assumption that a low-grade infectious process might trigger excessive inflammatory reaction after wrapping. 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The pathogenetic mechanisms underlying this process are unknown. We report on a patient who developed a space-occupying granulomatous abscess after wrapping of an unruptured aneurysm of the M2/M3 bifurcation. The patient underwent revision craniotomy for abscess removal. The aneurysm was explored and found to be completely thrombosed and excluded from the circulation. Exuberant granulomatous foreign-body reaction was pathologically confirmed and Candida parapsilosis was isolated from the pus. The patient underwent an antifungal treatment regimen and recovered with no residual neurological deficits. Our findings support the assumption that a low-grade infectious process might trigger excessive inflammatory reaction after wrapping. 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| subjects | Aged Angiography, Digital Subtraction Antifungal Agents - therapeutic use Brain Diseases - diagnosis Brain Diseases - etiology Brain Diseases - microbiology Brain Diseases - pathology Brain Diseases - surgery Candida parapsilosis Candidiasis - drug therapy Candidiasis - etiology Female Foreign-Body Reaction - etiology Foreign-Body Reaction - pathology Foreign-Body Reaction - surgery Granuloma - diagnosis Granuloma - etiology Granuloma - microbiology Granuloma - pathology Granuloma - surgery Humans Intracranial Aneurysm - diagnosis Intracranial Aneurysm - surgery Magnetic Resonance Imaging Neurosurgical Procedures - adverse effects Surgical Mesh - adverse effects |
| title | Granuloma formation and occlusion of an unruptured aneurysm after wrapping |
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