Nishant Desai

As a neurosurgeon, let me tell you how frightening this injury actually is - an occipital compound depressed skull fracture treated with a WIDE craniotomy (outer staple line). What's scary isn't the fracture; it's what's adjacent to the damaged skull. The axe blows (that tree-branch scar at the center) hit right over the posterior superior sagittal sinus, a large vein that runs lengthwise between the 2 cerebral hemispheres and carries blood from the brain to the heart. Penetrating injuries to the sinus can carry upwards of a 40% morbidity/mortality - partially because a transection of the sinus can be difficult to repair and can result in extreme blood loss, venous air embolism, or thrombosis - all of which can be fatal. There's scary, and then there's the "you go to elevate the fracture and risk unroofing the sinus, losing 2 liters of blood in a minute" scary. The surgeons likely had their hands full and did an amazing job. Divine providence called many heroes into service that day. Damn fine work. धन्यवाद