Disturbing CCTV footage shows the pensioner, known only as Carmen, being knocked unconscious after the assault by Troy Andrew Sargent in Perth, Australia in March.
Sargent, 36, approached the elderly gran at an ATM cash machine in the suburb of Kardinya and appeared to reach for her back pocket.
Her granddaughter Jacqui, 29, then asked the troubled man if he had stolen money from Carmen, reports Nine News.
Seconds later, Sargent punches the 29-year-old in the face as she stands beside her grandmother.
As Carmen consoles Jacqui after the horrifying attack, the large 36-year-old man then launches a flying kick at the back of the younger woman.
The kick knocks the heads of the women together before sending the pensioner crashing to the ground.
In the clip, her skull can be seen smashing off the concrete – a blow which the 90-year-old said knocked her unconscious.
Doctors later told a Perth court that the attack could have killed Carmen.
Speaking about the attack, the grandmother said: “I couldn't believe it was happening and then I was knocked out, my head on the pavement and I couldn't remember much.”
A court heard how paranoid schizophrenic Sargent believed the two women were witches and had cast spells on him.
The attacker was off his medication when he carried out the terrifying attack which was part of a three-day rampage in which he attacked a neighbour with a metal pole and punched a hospital worker.
He was jailed for 11 months for the assault which left the vulnerable gran with two black eyes and stitches on her face.
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