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Symptomatic Granuloma Secondary to Embolic Agent: A Case Report
Prashant Gunawat1, Salman Tehran Shaikh2, Vikram Karmarkar1
1Consultant Neurosurgeon, Department of Neurosurgery, Bombay Hospital Institute of Medical Sciences , Mumbai, Maharashtra, India .
Journal of Clinical and Diagnostic Research : JCDR
|January 5, 2017
Summary
Onyx liquid embolic agent can cause granuloma formation in brain tissue after arteriovenous malformation embolization. This rare complication required surgical removal and presented with limb weakness and seizures.
Area of Science:
- Neurology
- Interventional Radiology
- Pathology
Background:
- Onyx is a widely used liquid embolic agent for treating cranial vascular malformations such as arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs).
- Its mechanism involves inducing thrombosis and occlusion within the vascular nidus through an inflammatory response.
Observation:
- This case report details a rare instance where Onyx embolization for an AVM resulted in the formation of a granuloma in the surrounding brain tissue.
- The patient presented with neurological deficits including limb weakness and seizure episodes.
Findings:
- Histopathological examination confirmed a foreign body inflammatory reaction consistent with granuloma formation.
- Surgical excision was required to address the complication.
Implications:
- This case highlights a potential, albeit uncommon, adverse reaction to Onyx embolization, emphasizing the importance of careful technique to prevent extravasation.
- It underscores the need for vigilance in monitoring patients post-embolization for delayed neurological complications and the potential necessity of surgical intervention.