London: Maxillofacial consultant surgeon Ashraf Messiha said it was a “miraculous” survival for Ohoud Al Najjar, who has been bedridden since the April 6 attack at a hotel in London. She was found with her brain protruding from a hole in her head.

Ohoud, 34, and her sisters Khulood, 36, and and Fatima, 31, suffered fractured skulls and life-threatening injuries in the attack after they were bludgeoned with a hammer by Philip Spence, who is currently on trial over the brutal attack.

Mesh titanium plates were implanted in Ohoud’s skull. Her upper jaw was cracked in two and her teeth smashed, Messiha told jurors. She still struggles with swallowing and speech, but can now make “fine” movements such as pick up a pair of glasses and wear them, Messiha told the court.

“In my opinion it is a miraculous recovery... We were actually not expecting her to survive,” he said.

Fatima suffered three brain injuries. She now suffers a deformity of the nose. She also sustained a perforated eardrum and has a damaged facial nerve.

Khulood’s eye sockets were shattered, her forehead and jaw fractured and a facial nerve damaged. She sustained a fracture to her lower left arm, jurors heard.

Forensic pathologist Dr Ashley Feagan-Earl estimated Fatima suffered at least three blows from the hammer, Khulood a minimum of six blows and Ohoud an “absolute minimum” of four blows. The level of force was “severe”, he said.