Rapid Neurological Alteration Associated with Concave Deformity of the Skin Flap in a Craniectomized Patient. Case Report

Rapid neurological alteration was observed in association with concave deformity of the skin flap following a large decompressive craniectomy. In an erect position, hemiparesis and dysphasia showed marked deterioration with a sinking skin flap and CT-scan showed considerable distortion of the underl...

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Published inNeurologia medico-chirurgica Vol. 20; no. 1; pp. 89 - 93
Main Authors NAKAMURA, Takao, TAKASHIMA, Tsuneo, ISOBE, Katsumi, YAMAURA, Akira
Format Journal Article
LanguageEnglish
Published Japan The Japan Neurosurgical Society 1980
Subjects
Adult
Brain Injuries - complications
Brain Injuries - surgery
cranioplasty
Craniotomy
decompressive craniectomy
Electroencephalography
Hematoma, Subdural - surgery
Humans
Male
shunt operation
Sinking skin flap
Surgical Flaps
Tomography, X-Ray Computed
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Summary:Rapid neurological alteration was observed in association with concave deformity of the skin flap following a large decompressive craniectomy. In an erect position, hemiparesis and dysphasia showed marked deterioration with a sinking skin flap and CT-scan showed considerable distortion of the underlying brain tissue. Those changes were rapidly improved by restoration of normal curvature of the skin flap in a supine position. EEG findings coincided with such rapid alteration. Neurological changes may be due solely to concave deformity of the skin flap and the underlying brain tissue; this characteristic phenomenon might be described as “the syndrome of the sinking skin flap.” The presence of shunt system seems to play an important role in appearance of such a phenomenon.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ISSN:0470-8105
1349-8029
DOI:10.2176/nmc.20.89