PMC7289748_01
Initial presentation of patient in ER. The wooden foreign body penetrated through the left nasolabial fold.
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On neurological examination, a decreased blink reflex on his left eye was found, but signs of basilar skull fracture (e.g. raccoon eyes, rhinorrhea, and otorrhea) and muscle weakness or sensory impairment in all 4 limbs were not found (Medical Research Council (MRC) Scale 5/5) (Fig. 1).
Preoperative NECT described a low-attenuated area in the left lobe of cerebellum (yellow arrow).
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The length of the object was 152.1 mm embedded in situ (Fig. 2, Fig. 3, Fig. 4).
Preoperative 3D head CT reconstruction showed foreign the foreign wooden body penetrated the man's left nasolabial fold.
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The length of the object was 152.1 mm embedded in situ (Fig. 2, Fig. 3, Fig. 4).
The total length of the foreign wooden body was 49.4 x 4 cm, divided into two parts which are in-situ part (19 x 2.6 cm) and ex-situ part (30.7 x 4 cm).
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The total length of the foreign wooden body is 49.4 x 4 cm, the measurement of in-situ part was 19 x 2.6 cm, while the measurement of ex-situ part was 30.7 x 4 cm (Fig. 5).
A & B. Postoperative neurological examination, facial nerve palsy were found.
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Facial nerve palsy and paresthesia of the trigeminal nerve were found (Fig. 6A & B).
Thirty day postoperative enhanced head CT images showed a formation cystic mass in the left lobe of the cerebellum with blood density lesions and visible ring enhancement. These features suggested a formation of cerebellar abscess.
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It measured 20 x 28 mm with blood density lesions and visible ring enhancement (Fig. 7).
Three month postoperative enhanced head CT images showed the brain abscess was relatively consistent with its previous size, shape, and location.
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Later on, enhanced head CT was repeated and revealed that abscess' size, shape, and location were consistent compared to previous enhanced head CT's result (Fig. 8).