PMC5022070_01
Machete inflicted wound to the right side of the head, penetrating up to the cranium.
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Intraoperative photograph showing the craniectomy window using the same incision the machete did in the scalp.
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After neurological status deterioration was observed in the ED, we decided to rush the patient into the operating room (OR) for exploration and craniotomy, the incision was performed by extending the machete cut through the scalp to allow better visualization for craniotomy, a linear skull fracture in concordance with direction of the machete cut was observed, craniotomy was performed, observing bone shrapnel fragments penetrating the dura as well as a linear incision that went through the dura and into the parenchyma aligned with the machete cut, bone shrapnel fragments were removed and a U shaped dural incision performed, cerebral edema was evident after dural opening (Fig. 3), a debridement of bone fragments and pulped encephalic tissue was performed, and decompressive craniectomy was decided extending the bone flap limits to the base of the skull.
Timeline of the most relevant data events of the case report.
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Timeline of the most relevant events is depicted on Fig. 4.