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[Syndrome of the trephined]
I Martínez-Viñuela1, I Paredes-Borrachero2, M Rubio-Mellado1
1Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario de Toledo, Toledo, España.
Rehabilitacion
|January 8, 2021
Summary
Syndrome of the trephined (SoT) is neurological decline after decompressive craniectomy. Early rehabilitation and bone replacement can reverse SoT symptoms, highlighting its underdiagnosis and treatable nature.
Area of Science:
- Neurology
- Neurosurgery
- Rehabilitation Medicine
Background:
- Decompressive craniectomy is a life-saving procedure for elevated intracranial pressure.
- Syndrome of the trephined (SoT) describes neurological deterioration following craniectomy without bone replacement.
- SoT is often underdiagnosed, presenting with a variable incidence.
Observation:
- A stroke patient in the Critical Care Unit experienced altered consciousness and sudden motor deficits.
- The patient's symptoms were diagnosed as Syndrome of the trephined (SoT).
- Initial management involved rehabilitation with early postural changes to alleviate symptoms.
Findings:
- Syndrome of the trephined (SoT) is characterized by neurological decline post-decompressive craniectomy.
- Symptom reversal is typically achieved through bone flap replacement, the definitive treatment for SoT.
- Rehabilitation interventions can offer temporary symptom amelioration pending definitive surgical treatment.
Implications:
- Increased awareness and diagnosis of SoT are crucial for appropriate patient management.
- Early rehabilitation may improve outcomes for patients with Syndrome of the trephined.
- Bone flap replacement remains the gold standard for treating neurological deficits associated with SoT.
