HighlightsWe 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.

Gliomas are the most frequent supratentorial intracranial tumors in the pediatric population. Usually, they are intra-axial lesions with a characteristic image pattern, however, there are few reported cases of gliomas with exophytic growth. There are no previous reports in the literature of gliomas with exophytic growth in the Sylvian fissure. Fourteen year-old female patient who started with seizures. In imaging studies, a neoplasic mass with an exophytic portion in the left Sylvian fissure was found. Macroscopically, total resection was performed, definitive diagnosis was anaplastic astrocytoma. She presented recurrence and is currently receiving adjuvant treatment. Supratentorial gliomas with exophytic growth are extremely rare. We report the first case in the pediatric population, and we consider it is important to know its imaging and macroscopic characteristics for its initial management and to take it into account as a differential diagnosis of exophytic lesions.

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