Montemurro Nicola, Murrone Domenico, Romanelli Bruno, Ierardi Aldo
Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy.
Case Rep Neurol. 2020 Jan 9;12(1):7-12. doi: 10.1159/000505233. eCollection 2020 Jan-Apr.
During craniotomy, hemostatic materials such as oxidized cellulose and cotton pads, commonly used to control bleeding, may cause a granulomatous reaction that may produce space-occupying mass lesions termed textiloma (or gossypiboma). We present a 46-year-old female who underwent a right frontotemporal craniotomy and surgical removal of intraparenchymal cerebral hemorrhage, and who developed a textiloma during the postoperative period causing seizures. Granulomatous reactions due to hemostatic agents have been reported experimentally, as well as after cranial and spinal operations. We emphasize that although it is rare, an adverse reaction such as a postoperative textiloma due to hemostatic material and subsequent granuloma formation can result in a false image of rebleeding, tumor recurrence, radiation necrosis, or postoperative abscess, depending on the particular clinical history of each patient.
在开颅手术期间，常用于控制出血的止血材料，如氧化纤维素和棉垫，可能会引起肉芽肿反应，进而产生占位性肿块病变，称为纺织瘤（或棉球瘤）。我们报告一例46岁女性，她接受了右额颞开颅手术并手术清除脑实质内脑出血，术后发生纺织瘤并导致癫痫发作。止血剂引起的肉芽肿反应在实验研究中已有报道，在颅脑和脊柱手术后也有发生。我们强调，尽管这种情况罕见，但由于止血材料导致的术后纺织瘤及随后的肉芽肿形成等不良反应，根据每位患者的具体临床病史，可能会导致再出血、肿瘤复发、放射性坏死或术后脓肿的假象。
