This is the horrific outcome when a 12-year-old boy’s skull was impaled on steel spike during a row with a classmate.

Shocking images of the boy – named as Muhammad Antar Muhammad in local media in Mansoura, Egypt – show him with the file embedded in his head under his left ear.

The spike – which would usually have a handle covering it – had penetrated 5 cm into Muhammad’s skull.

Five hours of painstaking surgery meant part of Muhammad’s skull had to be removed and then replaced so medics could get at the injury.

Officials at the University Emergency Hospital say he is recovering in an intensive care unit ward.

Medics praised those that had called emergency services and did not attempt to remove the file until the boy could be hospitalised and the file removed professionally.

Medics said it is still too early to know what lasting damage will be caused by the horrific injury.

Local police are reportedly investigating the incident, although it is believed the other attacker was under the age of criminal responsibility.

Police did not reveal the cause of the argument that caused one of the youngsters to use the file as a weapon and ram it into the rival’s head.