An 11-year-old boy accidentally stuck his soft palate by himself with a 46-cm-long branch of bamboo when he was getting on a handmade swing and fell down from it. He removed the branch immediately from the soft palate by himself, and visited Nagano Red Cross Hospital on that day because of oral pain. He was conscious, but presented with rhinolalia and had hyperesthesia of the skin in the region of the maxillary nerve. Examination of the soft palate revealed a bruise 5 millimeters in diameter without bleeding, and a cranial computed tomographic scan revealed no clinically significant findings. During 2 days’ observation in our hospital, he became feverish, complained of headache, and was drowsy with a stiff neck because of secondary bacterial meningitis. Cranial magnetic resonance imaging demonstrated clear traces of the penetrated branch that entered the soft palate and reached the cerebellum. He received antibiotics for 3 weeks and recovered without sequelae. We consider that careful observation is necessary in patients with oral injury, even without any clinically significant symtoms or signs at the time of initial examination, because of occult critical conditions such as bacterial meningitis or central nervous system injury.
