Postoperative Textiloma Mimicking Intracranial Rebleeding in a Patient with Spontaneous Hemorrhage: Case Report and Review of the Literature

Abstract

During craniotomy, hemostatic materials such as oxidized cellulose and cotton pads, commonly used to control bleeding, may cause a granulomatous reaction that may produce spaceoccupying mass lesions termed textiloma (or gossypiboma). We present a 46-year-old female who underwent a right frontotemporal craniotomy and surgical removal of intraparenchymal cerebral hemorrhage, and who developed a textiloma during the postoperative period causing seizures. Granulomatous reactions due to hemostatic agents have been reported experimentally, as well as after cranial and spinal operations. We emphasize that although it is rare, an adverse reaction such as a postoperative textiloma due to hemostatic material and subsequent granuloma formation can result in a false image of rebleeding, tumor recurrence, radiation necrosis, or postoperative abscess, depending on the particular clinical history of each patient.

Clinical Risk and Overall Survival in Patients with Diabetes Mellitus, Hyperglycemia and Glioblastoma Multiforme. A Review of the Current Literature

“…In the last years, there is a growing interest in the literature about the impact of DM2 and hyperglycemia on clinical outcome in cancer patients. Diabetes and obesity are associated with an increased requirement for surgical procedures throughout life and furthermore diabetes and obesity themselves represent risk factors for several surgical treatments, as they are associated with increased postoperative morbidity and mortality [ 58 , 59 , 60 , 61 , 62 ]. Adverse outcomes include surgical site infections, impaired wound healing, implant failure and medical complications [ 59 ].…”

Posttraumatic synchronous double acute epidural hematomas: Two craniotomies, single skin incision

“…[ 7 ] However, in our case, no injury of the sigmoid sinus nor transverse sinus was found and the bleeding was easily controlled with hemostatic agents. [ 9 ] However, a diastatic fracture of the lambdoid suture potentially represents itself a cause of instant death and it is associated to an unfavorable outcome. [ 7 ] Huda et al .…”

Clinical Issues—October 2020

“…Depending on the type, size, and location of the retained material and patient‐specific factors, development of the intracranial FBG and subsequent detection may take several years . Case reports of retained textiles after cranial procedures show how an FBG can mimic a serious condition such as a tumor, an abscess, or an intracranial hemorrhage . Complications of intracranial FBGs may include seizure, weakness, vision changes, or other neurologic symptoms and may require reoperation …”

“…Another case study described a 46‐year‐old woman who developed seizures 10 days after cranial surgery to evacuate a right frontotemporal intraparenchymal cerebral hemorrhage. Magnetic resonance imaging scans showed a dense mass reported to be a textiloma …”