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Inadvertent Foreign Body Embolization in Diagnostic and Therapeutic Cerebral Angiography

P. Shannonb, J.M. Billbaoa, T. Marottac and K. Terbrugged

a Department of Pathology and Laboratory Medicine, Sunnybrook & Women’s Health Sciences
b Division of Neuropathology, Sunnybrook & Women’s Health Sciences
c Diagnostic and Therapeutic Neuroradiology, St. Michael’s Hospital
d Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada


Figure 1
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  		Fig 1. A, CT scan of patient 1, 2 days after angiography, demonstrating right anterior and middle cerebral artery territory infarcts, as well as a ventricular drain in situ. B, Section of middle cerebral artery containing recent thrombus and a particle of polyvinyl alcohol (arrow, hematoxylin phloxine saffron, x200). C, Small leptomeningeal artery demonstrating acute cellular reaction and thrombosis and (D) under polarized light, strongly birefringent, hollow fibers characteristic of cotton (C and D, hematoxylin phloxine saffron, x630).


Figure 2
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  		Fig 2. A, Brain of patient 2 with cavitating infarct (arrowhead) in left lentiform nucleus and (B) adjacent perforating artery containing foreign body reaction and cotton fibers (hematoxylin and eosin, x200).


Figure 3
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  		Fig 3. A, Leptomeningeal artery in patient 3, demonstrating recanalized artery (arrowhead) immediately adjacent to infarcted brain (arrow, Martius Scarlet blue, x100). B, Subintimal foreign body reaction containing foreign material (Martius Scarlet blue, x1000).


Figure 4
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  		Fig 4. Resected arteriovenous malformations with (A) glue admixed with birefringent cotton fibers (arrowheads, Elastic Masson Trichrome, x200) or (B) within medial foreign body giant cells (hematoxylin phloxine saffron PS, x100).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X