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Removal of Bamboo Fragments Transorbitally Penetrated into the Cerebellum and Temporal Lobe 30 Years after the Injury Yosuke KUROMI 1 , Taku SATO 1 , Hitoshi ANDO 1 , Yuka MATSUMOTO 1 , Keiko ODA 1 , Eiji ITO 1 , Masahiro ICHIKAWA 1 , Tadashi WATANABE 1 , Jun SAKUMA 1 , Kiyoshi SAITO 1 1Department of Neurosurgery, Fukushima Medical University Keyword: transorbital , penetration , bamboo , brain abscess pp.979-983
Published Date 2012/11/10
DOI https://doi.org/10.11477/mf.1436101857
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 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.


Copyright © 2012, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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