Foreign Body Reaction Mimicking Intracranial Abscess following the Use of Oxidized Regenerated Cellulose (SurgicelTM): Case Report and Literature Review

Background & Importance Uncontrolled bleeding has to be absolutely avoided in brain surgery. For this purpose, neurosurgeons use topical haemostatic agents in their practice (3). Because of the delicate nature of intracranial tissues, commonly bioabsorbable materials such as oxidized regenerated cellulose (SurgicelTM; Ethicon, Inc., Somerville, NJ) have been used and left in the surgical field in order to prevent re-bleeding after closure (10). This practice may induce a rare granulomatous inflammatory reaction close to and onto the surgical site (6). This may lead to symptoms and/ or neuroradiological findings such as mass lesions virtually indistinguishable from recurrent tumor or postoperative intracranial abscesses at CT-MRI scans (7). The occurrence of granulomatous inflammatory foreign body reaction due to the use of oxidized regenerated cellulose (SurgicelTM; Ethicon, Inc., Somerville, NJ) is extremely rare: only few cases were published (2,5-9). We report a case of 54 year-old man previously operated for intracranial meningioma who underwent surgery again for a granulomatous foreign body reaction mimicking postoperative brain abscess.