Severe Craniocerebral Injury in a Child Caused by Repetitive Cleaver Strikes: Case Report and Review of the Literature

Keyu Yan ¹, Shuai Wang ¹, Guanhui Li ¹

⁰Department of Neurosurgery The Second Hospital of Hebei Medical University Shijiazhuang China.

Clinical Case Reports +

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December 25, 2025

View abstract on PubMed

Summary

This case study details a rare pediatric severe open craniocerebral injury from a cleaver. Multidisciplinary team management led to successful surgical repair and significant neurological recovery.

Area Of Science

Pediatric Neurosurgery
Trauma Surgery
Critical Care Medicine

Background

Severe open craniocerebral injuries are uncommon in children.
Such injuries, particularly from sharp instruments like cleavers, are exceptionally rare.
This case involves a child with a severe open head injury due to repeated chopping blows.

Purpose Of The Study

To report an exceptional case of pediatric severe open craniocerebral injury.
To highlight the importance of multidisciplinary team (MDT) management in such cases.
To discuss the surgical and rehabilitation strategies for optimizing outcomes.

Main Methods

Immediate organization of a multidisciplinary team (MDT) for evaluation and treatment.
Preoperative imaging to assess the extent of skull fracture, scalp laceration, and brain injury.
Emergency surgery including debridement, hemostasis, fragment removal, and dural repair.
Postoperative intensive care unit (PICU) monitoring and systematic rehabilitation.
Second-stage cranial repair for skull reconstruction and aesthetic improvement.

Main Results

The child presented with traumatic hemorrhagic shock and extensive injuries.
Emergency surgery successfully addressed the acute trauma, including hemorrhage control.
Postoperative care involved intensive monitoring and rehabilitation.
A second-stage surgery restored cranial integrity.
At 6-month follow-up, significant neurological recovery was observed with no major deficits.

Conclusions

Multidisciplinary team (MDT) management is crucial for severe pediatric open craniocerebral injuries.
Prompt surgical intervention and comprehensive rehabilitation are key to favorable outcomes.
Effective management can optimize prognosis and minimize complications in these rare cases.

Keywords:

comminuted skull fracture multidisciplinary team pediatric traumatic brain injury repetitive craniocerebral injury