Traumatic brain injury with a machete penetrating the dura and brain: Case report from southeast Mexico

•We present the first case of a penetrating non missile cranial injury with a machete in Mexico.•The case was managed in accordance to current algorithms presented in the literature for the management of non-missile penetrating (NMP) cranial injuries, ultimately requiring a decompressive craniectomy, with good outcome.•The use of current algorithms for managing NMP cranial trauma has proved to be very useful when applied on this particular case.•Glasgow Coma Scale on admission is an important prognostic factor in NMP cranial trauma.

IntroductionTraumatic Brain Injury (TBI) is a major cause of death and disability in our society, we present the first case report of non-missile penetrating (NMP) cranial trauma with a machete in Mexico, and our objective by presenting this case is to prove the usefulness of recently proposed algorithms in the treatment of NMPPresentation of caseWe present the case of a 47 year old woman who received a machete hit to the right side of her head during an assault., she arrived fully conscious to the emergency department (ED), computed tomography was performed and based on the findings of this study and in accordance to recently proposed algorithms for managing NMP cranial trauma a craniotomy was performed, at follow-up the patient presented wtih minor neurological disability in the form of left hemiparesis.DiscussionNon-missile penetrating (NMP) lesions are defined as having an impact velocity of less than 100 m/s, causing injury by laceration and maceration, An algorithm for treating NMP cranial trauma has been recently published in the Journal World Neurosurgery by De Holanda et al., in this case we followed the algorithm in order to provide best care available for our patient with good results.ConclusionThe use of current algorithms for managing NMP cranial trauma has proved to be very useful when applied on this particular case. GCS on admission is an important prognostic factor in NMP cranial trauma.