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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0045-1809559
Review Article

Severe Head and Brain Trauma Due to Machete Wounds

Luis Rafael Moscote-Salazar 
1   Department of Research, Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
2   Department of Research, AV Healthcare Innovators, LLC, Madison, Wisconsin, United States
4   School of Medicine, University of Cartagena, Cartagena, Colombia
5   Department of Research, Aneuclose LLC, Eagan, Minnesota, United States
,
Md Moshiur Rahman 
6   Department of Neurosurgery, Holy Family Red Crescent Medical College, Dhaka, Bangladesh
,
Bibha Osti 
7   Medical Office in Spinal Injury Rehabilitation Center, Kathmandu, Nepal
,
William Florez 
1   Department of Research, Colombian Clinical Research Group in Neurocritical Care, Bogota, Colombia
,
Tariq Janjua 
6   Department of Neurosurgery, Holy Family Red Crescent Medical College, Dhaka, Bangladesh
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Abstract

Serious cranial and brain injuries from machete wounds are an uncommon yet serious type of penetrating cranial injury, which can be associated with significant morbidity and mortality. Injuries from machete wounds may present with intricate patterns of skull fractures, brain contusions, intracranial hemorrhage, and deficits related to trauma to the brain. The clinical condition appears to be the principal determinant of prognosis, with most individuals sustaining injury with machete wounds having a poor outcome despite the provision of aggressive care. This narrative review will evaluate the clinical variables, imaging findings, management, and outcomes in association with acute or severe cranial injury secondary to machete wounds. The review will also include a case report of a 47-year-old male motorcycle passenger who sustained severe cranial trauma with upper limb injuries due to a machete assault. While the male underwent surgery and was subsequently provided with comprehensive critical care management, the individual suffered severe brain complications of cerebral edema and ischemic injury leading to herniation of the brain, ultimately leading to death. The review aimed to illustrate sequential imaging, particularly computed tomography imaging, as early as possible to characterize the extent of the damage and facilitate management decisions. Although the findings demonstrate that surgery may improve survival in patients sustaining injury from machete wounds, the overall prognosis could be poor due to the degree of the injury. Multidisciplinary management, which consists of urgent neurosurgical intervention, concomitant intensive care, and ongoing monitoring, is required for improved outcomes.

Keywords

severe head and brain trauma - machete injuries - penetrating cranial injury - neurosurgical management - brain contusion - intracranial hemorrhage - CT imaging - malignant edema - cerebral ischemia - traumatic brain injury


Publication History

Article published online:
13 June 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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