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Foreign-body reaction mimicking postneurosurgical infection after cranioplasty
David M Brett-Major1, Sean M Baraniak, Jonathan E Gilhooly
1Division of Infectious Diseases, National Naval Medical Center, Bethesda, MD 20889-5600, USA.
Abstract:
The case of a 57-year-old woman who suffered a fall is presented. After a polymethyl malacrylate revision cranioplasty, she presented with signs, symptoms, and intraoperative findings consistent with postneurosurgical infection. Dural foreign-body reaction was diagnosed, and parenteral antibiotic therapy was discontinued successfully.
Insights
A woman developed a post-neurosurgical infection after polymethyl malacrylate revision cranioplasty. Prompt diagnosis of dural foreign-body reaction led to successful discontinuation of antibiotic therapy.
Area of Science:
- Neurosurgery
- Infectious Disease
- Biomaterials Science
Background:
- Revision cranioplasty using polymethyl malacrylate (PMMA) is a complex procedure.
- Post-neurosurgical infections pose significant challenges in patient management.
- Foreign-body reactions can mimic or complicate infectious processes.
Observation:
- A 57-year-old female patient experienced a fall, necessitating a PMMA revision cranioplasty.
- Following surgery, the patient exhibited clinical signs and symptoms suggestive of a post-neurosurgical infection.
- Intraoperative findings further supported the suspicion of infection.
Findings:
- The patient was diagnosed with a dural foreign-body reaction.
- This diagnosis was distinct from a typical bacterial or fungal infection.
- Parenteral antibiotic therapy was successfully withdrawn after diagnosis.
Implications:
- Highlights the importance of considering foreign-body reactions in the differential diagnosis of post-cranioplasty complications.
- Suggests that aggressive antibiotic treatment may not always be necessary for dural foreign-body reactions.
- Emphasizes the need for accurate histopathological assessment in managing complex neurosurgical cases.
