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Abstract - Case Report

J Cerebrovasc Endovasc Neurosurg. 2020 22(4): 267-272
The Journal of Cerebrovascular and Endovascular Neurosurgery
Foreign body granuloma reaction after endovascular therapy of an unruptured right frontal arteriovenous malformation
Roberto Colasanti2,3, Cesar Chian4,
2Department of Neurosurgery, Umberto I General Hospital, Università Politecnica delle Marche, Ancona, Italy, 3Department of Neurosurgery, Ospedali Riuniti Marche Nord, Pesaro, Italy, 4Department of Pathology, Alberto Hurtado School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru

Foreign body reactions after endovascular procedures for brain arteriovenous malformations are extremely rare. We report the case of a cerebral foreign body granuloma reaction after embolization of a frontal arteriovenous malformation with Onyx. A previously treated 36-year-old man underwent re-embolization of a residual and recurrent unruptured right frontal vascular malformation with Onyx. The post-procedural imaging revealed a right frontotemporal heterogeneously enhancing expansive lesion associated with a residual malformation. Following microsurgical resection, the histopathological examination of the expansive lesion revealed basophilic foreign body like deposits adjacent to multi-nucleated giant cells, highly compatible with cerebral foreign body granulomas reaction to Onyx. The clinical and radiological follow-up of the patient was favorable after complete resection of the lesions.
Key words : Brain arteriovenous malformation, Embolization, Endovascular therapy, Foreign body granuloma, Onyx

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