Lopez-Calle Jaime, Colasanti Roberto, Chian Cesar, Choque-Velasquez Joham
Department of Surgery-Neurosurgery, Arzobispo Loayza National Hospital, Lima, Peru.
Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Ancona, Italy.
J Cerebrovasc Endovasc Neurosurg. 2020 Dec;22(4):267-272. doi: 10.7461/jcen.2020.E2019.09.006. Epub 2020 Dec 4.
Foreign body reactions after endovascular procedures for brain arteriovenous malformations are extremely rare. We report the case of a cerebral foreign body granuloma reaction after embolization of a frontal arteriovenous malformation with Onyx. A previously treated 36-year-old man underwent re-embolization of a residual and recurrent unruptured right frontal vascular malformation with Onyx. The post-procedural imaging revealed a right frontotemporal heterogeneously enhancing expansive lesion associated with a residual malformation. Following microsurgical resection, the histopathological examination of the expansive lesion revealed basophilic foreign body like deposits adjacent to multi-nucleated giant cells, highly compatible with cerebral foreign body granulomas reaction to Onyx. The clinical and radiological follow-up of the patient was favorable after complete resection of the lesions.
脑动静脉畸形血管内介入治疗后的异物反应极为罕见。我们报告了1例使用Onyx栓塞额叶动静脉畸形后发生脑异物肉芽肿反应的病例。一名36岁曾接受过治疗的男性，因右侧额叶未破裂的残留复发性血管畸形，接受了Onyx再栓塞治疗。术后影像学检查显示右额颞叶有一个不均匀强化的膨胀性病变，与残留畸形有关。显微手术切除后，对该膨胀性病变进行组织病理学检查，发现多核巨细胞附近有嗜碱性异物样沉积物，与Onyx引起的脑异物肉芽肿反应高度相符。病变完全切除后，患者的临床及影像学随访情况良好。
