J Korean Neurosurg Soc.  2008 Jan;43(1):51-53. 10.3340/jkns.2008.43.1.51.

"Syndrome of the Sinking Skin-Flap" Secondary to the Ventriculoperitoneal Shunt after Craniectomy

Affiliations
  • 1Department of Neurosurgery, Eulji University, Eulji Hospital, Seoul, Korea. grimi2@hanmail.net

Abstract

The syndrome of the sinking skin flap was introduced to explain the phenomenon of neurological deterioration after decompressive craniectomy. A 37-year-old man was admitted with acute subdural hematoma and traumatic intraparenchymal hematoma. After decompressive craniectomy, the patient suffered from hydrocephalus for which a ventriculoperitoneal (V-P) shunt was inserted. Following this procedure, the depression of the skin flap became remarkable and his mentation was deteriorated. The patient recovered uneventfully after temporary elevating of valve pressure and cranioplasty. We present a patient who was successfully managed with elevation of valve pressure and cranioplasty for the syndrome of the sinking scalp flap with review of a pertinent literature.

Keyword

Craniectomy; Cranioplasty; Syndrome of sinking scalp flap; Ventriculoperitoneal shunt

MeSH Terms

Adult
Decompressive Craniectomy
Depression
Hematoma
Hematoma, Subdural, Acute
Humans
Hydrocephalus
Scalp
Skin
Ventriculoperitoneal Shunt
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