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Reversible cerebral vasospasm and cerebral infarction secondary to meningitis following penetrating head trauma with bamboo
  1. Kunpei Takao1,
  2. Hiroyuki Matsuta2,
  3. Kumi Murata3 and
  4. Minoru Fujiki2
  1. 1Department of Neurosurgery, Oita University Hospital, Yufu, Oita, Japan
  2. 2Department of Neurosurgery, Oita University School of Medicine Graduate School of Medicine, Yufu, Japan
  3. 3Department of Forensic Medicine, Oita University School of Medicine Graduate School of Medicine, Yufu, Japan
  1. Correspondence to Dr Hiroyuki Matsuta; matsuta{at}


A man in the 70s fell on a bamboo and punctured his left upper eyelid. CT of the head showed fractures of the medial and superior walls of the left orbit, intracranial traumatic subarachnoid haemorrhage, intraventricular haematoma and left frontal cerebral contusion. He was treated conservatively. Despite prophylactic antibiotic therapy, he had prolonged loss of consciousness. A cerebrospinal fluid examination revealed bacterial meningitis. Imaging studies on day 15 showed extensive subacute cerebral infarction in the bilateral parieto-occipital lobes and main trunk artery stenosis. On day 31, MRA showed improvement of the main arteries, and cerebral vasospasm-induced cerebral infarction was diagnosed. He was transferred to rehabilitation with full assistance. The prognosis of bamboo perforation trauma is critical. Thus, preventing and treating central nervous system infection are considered the key to the prognosis. However, given the lack of established treatment for meningitis-associated cerebral vasospasm, case-specific treatment must be considered.

  • Neurological injury
  • Infection (neurology)
  • Stroke
  • Trauma CNS /PNS

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  • Contributors KT developed the concept and collected data for this manuscript and prepared a draft. HM was in charge of the patient’s care, revised and reviewed the draft, and obtained consent from the patient to submit the manuscript. KM was in charge of the patient’s care, revised the draft and prepared figures and tables. MF was responsible for the patient’s care and provided overall guidance in the preparation of the manuscript for submission and final approval.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.