Granuloma caused by oxidized cellulose following craniotomy

Three cases are reported in which large granulomas developed 13 to 21 months respectively after removal of intracranial meningiomas (2 cases) and after operation for an anterior communicating artery aneurysm. In each of the cases oxidized cellulose had been used and left in place for haemostasis. All of the granulomas acted as space-occupying lesions. They could be removed operatively with good result. All of them consisted of mononuclear phagocytic and multi-nuclear giant cells and contained remnants of oxidized cellulose. No comparable cases have been reported in the literature. Diagnosis, treatment and possible aetiological factors are discussed.