Delayed cerebral edema: Possible association with an inflammatory foreign body reaction

• Main Authors: Sook Young Sim, Chan-Young Choi
• Format: Article
• Language: English
• Published: Elsevier 2021-09-01
• Series: Interdisciplinary Neurosurgery
• Subjects: Cerebral edema; Complication; Foreign body; Inflammation; Meningioma; Postoperative
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214751921001195

Background: In general, most occurrences of peritumoral edema will undergo a gradual decrease in size after successful surgical removal of the tumor. However, delayed enlargement of cerebral edema several weeks after complete tumor removal without surgical complications is very rare. Case: A 60-year-old male presented with progressive clumsiness of his right hand and was diagnosed with a convexity meningioma. The tumor was completely resected and a few small pieces of oxidative cellulose and gelatin sponge were applied to the tumor resection bed for hemostasis. The patient had recurrent symptoms two weeks after surgery and follow-up images showed an extensive area of newly developed cerebral edema with subdural exudate containing a focal collection of gas. The clinical and radiologic findings were completely resolved with two weeks of steroid treatment and osmotherapy. Conclusion: An inflammatory foreign body reaction to surgical biomaterial can be associated with delayed cerebral edema and should be considered in the differential diagnosis.