title: Management Strategy of a Transorbital Penetrating Pontine Injury by a Wooden Chopstick.
abstract: BACKGROUND
  Transorbital penetrating pontine injuries from small spear-like objects, which are extremely rare, provide neurosurgeons with life-threatening and challenging conditions to manage.
  
  
  METHODS
  We present an unusual case of transorbital penetrating pontine injury and discuss imaging, diagnosis, management strategy, and anatomy-injury correlation. A 23-year-old man sustained a penetrating cranial injury from a bamboo chopstick that extended from the right orbit to the pons and cerebellum. Using a frontotemporal approach, we successfully removed the chopstick. Follow-up studies confirmed a good outcome.
  
  
  CONCLUSIONS
  Preoperative imaging, correct diagnosis, and surgical treatment are necessary to manage transorbital penetrating pontine injuries caused by spear-like objects, with specific attention paid to effective exposure and inventive means with total removal of the foreign object without causing further injury. A trajectory through the superior orbital fissure and paralateral to the cavernous sinus and into the pons seems to be the most prevalent and influences management of removal and injuries.
authors: Department of Neurosurgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China; Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
authors: Guozhu
authors: G
authors: Sun
authors: Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
authors: Kaan
authors: K
authors: Yagmurlu
authors: Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA; Department of Neurosurgery, Irkutsk State Medical University, Russian Federation.
authors: Evgenii
authors: E
authors: Belykh
authors: Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA.
authors: Ting
authors: T
authors: Lei
authors: Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, USA. Electronic address: Neuropub@dignityhealth.org.
authors: Mark C
authors: MC
authors: Preul
mesh_terms: D005547:Foreign Bodies / Q000000981:diagnostic imaging / Q000601:surgery*; D020197:Head Injuries, Penetrating / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures; D009915:Orbit / Q000000981:diagnostic imaging; D011149:Pons / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Foreign object; Penetrating orbitocranial injury; Pontine injury; Traumatic brain injury