Bone Fragment Granuloma Mimicking a Brain Tumor Following Placement of an Intracranial Pressure Monitoring System

Abstract

The placement of intracranial pressure (ICP) monitoring system requires drilling an orifice in the skull. Bone fragments can accidentally be inserted into the brain parenchyma while introducing the ICP monitoring system during the procedure. An intracranial granuloma can be subsequently formed if a non-specific reaction is induced and maintained by the inserted bone fragment in the brain parenchyma. These intracranial granulomas may eventually be confused with brain masses on follow-up imaging studies. We present the case of a 65-year-old male who underwent cranial surgery secondary to a severe traumatic brain injury (TBI). An intracranial bolt was initially placed contralaterally to measure the ICP. Eleven years later, a granuloma from a retained bone fragment secondary to the intracranial bolt placement was suspected. The clinical course, radiological investigations, and differential diagnosis are presented.

Commonly Used Assessment and Treatment for TBI Among Speech and Language Pathologist

“…A critical aspect of TBI is the formation of hematomas, which are blood clots within the brain or on its surface, and contusions, which are bruises on the brain tissue. These can occur either externally, between the brain and its protective covering, or internally, involving deeper brain structures (4,5). Not all cranial injuries necessitate medical intervention; however, significant trauma can cause skull fractures and potentially lead to brain damage (6,7).…”