Management Strategy of a Transorbital Penetrating Pontine Injury by a Wooden Chopstick.
BACKGROUND Transorbital penetrating pontine injuries from small spear like objects, which are extremely rare, provide neurosurgeons with life threatening and challenging conditions to manage. CASE DESCRIPTION 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.
World neurosurgery