Journal Article

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

Sun, Guozhu, Li, Guanhui, Tian, Longlong, Wang, Shuai, Yan, Keyu

2026

Overview

Severe craniocerebral injuries are rare in the pediatric population, especially open craniocerebral injuries caused by repeated slashes with sharp instruments. Here, we report an exceptional case of a child with severe open craniocerebral injury caused by repeated chopping blows with a cleaver. The child was admitted with traumatic hemorrhagic shock, and a multidisciplinary team (MDT) was immediately organized for evaluation and treatment decisions. Preoperative imaging showed a comminuted skull fracture accompanied by extensive scalp laceration and brain tissue injury with active hemorrhage. Emergency surgery included debridement, hemostasis, removal of the comminuted skull fragments, and dural repair. After surgery, the child was closely monitored in the Pediatric Intensive Care Unit (PICU) and received systematic rehabilitation. Three months later, the child underwent a second‐stage cranial repair to restore the integrity of the skull and improve the appearance of the head. At the 6‐month follow‐up, the child's neurological function had gradually recovered, with no significant cognitive or motor deficits. This case highlights the critical role of MDT management strategies in pediatric severe open craniocerebral injuries, including preoperative evaluation, surgical intervention, and postoperative rehabilitation, in order to optimize the child's prognosis and minimize the risk of complications. Key Clinical Message A severe pediatric open craniocerebral injury from repetitive sharp‐force trauma was managed via an MDT pathway comprising hemostatic resuscitation, damage‐control debridement with watertight dural repair, PICU infection prevention and seizure prophylaxis, early rehabilitation, and staged cranioplasty, with a good 12‐month functional outcome. Severe open craniocerebral trauma caused by repetitive cleaver strikes in a child.

• Publisher: John Wiley & Sons, Inc,Wiley
• Subject: Case Report / Case reports / Children & youth / comminuted skull fracture / Debridement / Edema / Emergency medical care / Fractures / Head injuries / Infections / Intellectual disabilities / Intensive care / Iodine / Medical imaging / multidisciplinary team / Neurosurgery / Paediatrics and Adolescent Medicine / pediatric traumatic brain injury / Pediatrics / repetitive craniocerebral injury / Self destructive behavior / Surgery / Teenagers / Tissues / Trauma / Traumatic brain injury