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AJNR - American Journal of Neuroradiology

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Temporal Lobe Intraparenchymal Retained Foreign Body from Remote Orbital Trauma

Joseph M. Aulino^a, Kymberly A. Gyure^b, Andrew Morton^d and John W. Cole^c

^a Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN
^b Department of Pathology, Baltimore, MD
^c Department of Neurology, Baltimore, MD
^d University of Maryland Medical Center, and American Radiology Services, Baltimore, MD

View larger version (151K): [in a new window]   FIG 1. Axial unenhanced CT image obtained through the level of the midbrain shows left temporal lobe hypoattenuation (arrows), reflecting vasogenic edema, predominantly involving white matter.

View larger version (87K): [in a new window]   FIG 2. Axial MR images obtained at the level of the temporal lobes. T1-weighted postcontrast image (A) shows a rim-enhancing, multilocular masslike lesion within the anterior left temporal lobe (arrows). The enhancement corresponds to the chronic granulation tissue surrounding the foreign body. FSE T2-weighted image (B) shows surrounding confluent T2-hyperintense vasogenic edema. Susceptibility effect (arrow) was preoperatively thought to reflect old blood products (hemosiderin) but most probably was the foreign body itself (likely fiberglass, according to the surgeon).

View larger version (91K): [in a new window]   FIG 3. Foreign body reaction. A, Acute and chronic inflammatory changes. A mixed inflammatory infiltrate, composed of neutrophils, lymphocytes, plasma cells, and macrophages, was present in the biopsy specimen (hematoxylin-eosin, original magnification x200). B, Segments of foreign material (hematoxylin-eosin, original magnification x400).