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Related Experiment Videos

Orthostatic mesodiencephalic dysfunction after decompressive craniectomy.

Philippe Bijlenga1, Daniel Zumofen, Hasan Yilmaz

  • 1Geneva University Hospital, Clinic of Neurosurgery, 24 rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland. philippe.bijlenga@hcuge.ch

Journal of Neurology, Neurosurgery, and Psychiatry
|November 23, 2006
PubMed
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A rare syndrome in decompressive craniectomy patients causes parkinsonian symptoms when upright. These neurological issues, including tremor and bradypsychia, resolved with horizontalization and cranioplasty.

Area of Science:

  • Neurology
  • Neurosurgery

Background:

  • Decompressive craniectomy is a life-saving procedure for increased intracranial pressure.
  • Post-craniotomy complications can manifest with complex neurological deficits.

Observation:

  • A patient developed a severe neurological syndrome including bradypsychia, dysarthria, limb rigidity, and parkinsonian tremor, exacerbated by upright posture.
  • Symptoms included abducens nerve palsy and mydriasis, resolving upon horizontalization.
  • Imaging revealed mesodiencephalic distortion correlated with orthostatic skin flap sinking.

Findings:

  • The syndrome, termed 'syndrome of the trephined,' was linked to postural changes and brainstem distortion.
  • Neurological deficits fluctuated with posture and were temporarily relieved by cranioplasty.

Related Experiment Videos

  • A custom helmet prevented symptom recurrence during cranioplasty infection management.

    • Implications:

    • This case highlights a distinct neurological syndrome associated with decompressive craniectomy and postural changes.
    • Understanding this syndrome is crucial for managing patients with large cranial defects.
    • Interventions like cranioplasty and external support devices can effectively manage symptoms.