Bamboo in the Brain—an Unusual Mode of Injury

Abstract

A 22-year-old male presented with a history of penetration of bamboo over the head which had fallen from the height of 40 ft. The position of the object was confirmed by computed tomography and patient underwent surgery immediately with removal of the object. The patient did well after surgery. Different modes of penetrating injury to the brain by bamboo and wooden objects, complications and management issues are discussed with a brief review of literature.

An unusual patterned injury from homicidal craniocerebral impalement with a metal chair leg

“…Non-missile penetrating injuries of the brain account for only about 0.4% of all head injuries [10]. Significant findings include cerebral lacerations and hemorrhage, as in the reported case, with a risk of subsequent sepsis in survivors potentially leading to later onset meningitis and/or brain abscesses [10].…”

“…Non-missile penetrating injuries to the head are most often accidental occurring during vehicle crashes or in falls from heights, including ladders [15][16][17][18]. Material such as falling bamboo poles also have the capacity to penetrate thicker parts of the skull such as the parietal bone [10]. One of the earliest described cases of a penetrating craniocerebral injury was that of Phineas Gage, a nineteenth century railway worker in the United States, who survived having a metal bar blown through his left frontal lobe, with a resultant frontal lobe syndrome [19].…”

Patterned injuries from screwdrivers

“…A screwdriver may be favored more in countries such as Greece where the possession of a concealed knife is illegal, but not a screwdriver [ 4 ]. Such non-projectile penetrating cerebral trauma is rare accounting for only about 0.4% of all head injuries [ 5 , 6 ] and has involved a variety of objects including crochet hooks, a toilet brush handle, an antler, scissors, knitting needles, crossbow bolts, glass, car antennas, crowbars, pitchforks, a chair leg, and umbrella ribs [ 4 , 7 – 10 ]. In attacks with screw drivers, the skull is usually penetrated in areas such as the orbital plates (as in the reported case) and the nasal or squamous temporal bones where the bone is thin [ 4 , 6 ].…”

竹材による穿通性頭部外傷後脳膿瘍に対して開頭術を施行した1例(Craniotomy for brain abscess after penetrating head injury by bamboo: a case report)

“…我々が渉猟した範囲では，竹材による穿通性頭部外傷は過去に11例 3), 4), 5), 6), 7), 8), 9), 10), 11), 12), 13)の報告がある。このうち，開頭術を行った症例は9例 3), 4), 5), 6), 7), 8), 9), 10), 13)存在し，全例で残存する竹片を認めた。脳膿瘍を合併していたのはそのうち5例 4), 5), 7), 10), 13)であった。また，開頭術を行った症例のうち本症例のように術前のCTまたはMRIで特定できなかった残存竹片は9例中5例 3), 5), 6), 7), 8)であった。…”

“…ある程度のサイズの残存異物であれば上述のようにCTやMRIで確認することはできるが，画像検査で残存異物を認めない場合でも，竹による穿通性頭部外傷では本症例や過去の症例報告のように細かい竹片が残存している可能性がある 3), 5), 6), 7), 8)。竹はイネ目イネ科タケ亜科に属する植物であり，構造的に，繊維方向に裂けやすく，縦方向の裂け目が発生すると全体が縦に裂けるという特徴がある 16)。穿通時の衝突により竹端部に裂け目が生じ，ささくれとなって散らばる可能性は高く，破片が残存しやすいと考えられる。…”