A 60-year-old Ohio teacher was so critically injured in a brutal attack at the hands of a student that she needed to undergo brain surgery.

The 15-year-old student punched the teacher in her head in a classroom, causing “a severe brain injury requiring extensive medical treatment,” according to an incident report obtained by The Cincinnati Enquirer, part of the USA TODAY NETWORK.

The student in Colerain Township, just outside of Cincinnati, has been charged in the attack and is being held in a juvenile jail. The teen, also accused of attacking a fellow student, is believed to have been under the influence of an unknown substance that caused him to hallucinate.