[A case of foreign body granuloma caused by cotton pledgets that remained during intracranial operation]

A case of intracranial foreign body granuloma is reported which was caused by cotton pledgets after total removal of meningioma. A 46 year-old woman was admitted on July 10, 1982, complaining of generalized convulsive seizures. CT and cerebral angiography revealed a left falx meningioma. The meningioma was totally removed under the left frontoparietal osteoplastic craniotomy. Microscopical findings were meningotheliomatous meningioma without malignancy. Despite the total removal, she developed two attacks of convulsion. Cerebral CT revealed a slightly high density mass with contrast-enhancement where the meningioma had been removed. Re-operation was performed on July 16, 1983. There was a granuloma with cotton fibers surrounded by yellow capsule without residual or recurrent meningioma. Only two cases have ever been reported in the literature so far reviewed. The differential diagnosis of foreign body granuloma is discussed and it is stressed to pay attention not to leave cotton pledgets during operations.