title: Surviving Penetrating Brainstem Injury by Bamboo Sticks: Rare Case Reports and a Brief Review of Literature.
abstract: BACKGROUND
  Chopsticks are common utensils used in many Asian cultures. However, they sometimes can be used as weapons or can cause accidents, particularly in children. Penetrating transorbital/transpharyngeal intracranial injuries with bamboo sticks are peculiar accidents and are relatively rare. Because of their rarity, the management of such injuries is often complex. We discuss 3 cases of penetration of the brainstem by bamboo sticks, 1 case through the foramen magnum, which, to the best of our knowledge, is the first reported case of such an injury.
  
  
  METHODS
  The case of a 50-year-old man who was stabbed with a pair of chopsticks in his left eye is presented. The chopsticks passed through the cavernous sinus, and the patient sustained superior orbital fissure syndrome. The other 2 cases were those of a 4-year-old girl having a similar pattern but different mechanism of injury and a 2-year-old boy who sustained transpharyngeal intracranial injury via the foramen magnum. Computed tomography, magnetic resonance imaging, and computed tomographic angiography (CTA) are the key imaging modalities frequently used to determine the course and extent of brain injury.
  
  
  CONCLUSIONS
  Early surgical exploration by a multidisciplinary team approach is essential for attaining a favorable outcome. All cases demonstrated good postoperative recovery and were successfully managed by removing the foreign body through its trajectory. We discuss and briefly review the literature on patterns, complications, and management issues of these less common injuries.
authors.affiliation: ‡Department of Neurosurgery, Xiangya Hospital of Central South University, Changsha, Hunan, China;§Department of Neurosurgery, Muhimbili Orthopedic and Neurosurgical Institute, Dar es Salaam, Tanzania.
authors.forename: Juma M
authors.initials: JM
authors.lastname: Mzimbiri
authors.forename: Jian
authors.initials: J
authors.lastname: Li
authors.forename: Yuguo
authors.initials: Y
authors.lastname: Xia
authors.forename: Jian
authors.initials: J
authors.lastname: Yuan
authors.forename: Jinfang
authors.initials: J
authors.lastname: Liu
authors.forename: Qing
authors.initials: Q
authors.lastname: Liu
mesh_terms: D002426:Cavernous Sinus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D002533:Cerebral Angiography; D002675:Child, Preschool; D005131:Eye Injuries / Q000601:surgery; D005260:Female; D005539:Foramen Magnum / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005547:Foreign Bodies / Q000601:surgery; D015600:Glasgow Coma Scale; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed