title: [Removal of bamboo fragments transorbitally penetrated into the cerebellum and temporal lobe 30 years after the injury].
abstract: A 37-year-old male presented with transorbitally penetrating bamboo fragments, which resulted in multiple brain abscesses during 30 years. Neurological examination revealed left blindness, oculomotor palsy, trigeminal nerve (V1) anesthesia, and cerebellar ataxia. Computed tomography demonstrated foreign bodies and two ring enhanced lesions in the cerebellum. Magnetic resonance imaging demonstrated a hypointense mass penetrating through the cavernous sinus into the posterior fossa, and another mass into the temporal lobe. Cerebral angiography showed that the sylvian vein drained to the pterygoid plexus. Two weeks after the drainage of two cerebellar abscesses using an endoscope, bamboo fragments were removed using a zygomatic anterior petrosal approach. Occlusion of the draining vein to the pterygoid plexus might cause temporal venous infarction. Using indocyanine green intraoperative angiography, we confirmed the collateral venous flow of the sylvian vein after temporary occlusion of the draining vein to the pterygoid plexus. Postoperative course was uneventful. Foreign bodies must be removed even after 30 years to prevent repetitive brain abscesses.
authors.affiliation: Department of Neurosurgery, Fukushima Medical University, Fukushima, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Kuromi
authors.forename: Taku
authors.initials: T
authors.lastname: Sato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ando
authors.forename: Yuka
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Keiko
authors.initials: K
authors.lastname: Oda
authors.forename: Eiji
authors.initials: E
authors.lastname: Ito
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ichikawa
authors.forename: Tadashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Jun
authors.initials: J
authors.lastname: Sakuma
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Saito
mesh_terms: D000328:Adult; D001922:Brain Abscess / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D002550:Cerebral Veins / Q000473:pathology / Q000601:surgery*; D005547:Foreign Bodies / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D013702:Temporal Lobe / Q000098:blood supply / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome