Severe Head and Brain Trauma Due to Machete Wounds

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.