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Unusual presentation in syndrome of trephined - A unique case observation
Hafiza Fatima Aziz1, Muhammad Waqas Saeed Baqai1, Rashid Jooma1
1Department of Neurosurgery, The Aga Khan University Hospital, Karachi, Pakistan.
Background:
Syndrome of trephined (SoT) is a well-recognized complication of decompressive craniectomy (DC). The understanding of SoT has improved more recently with the increasing utilization of DC for severely raised intracranial pressure. It usually presents after a period of weeks or months with a cluster of adverse neurological symptoms, most commonly with worsening of motor strength.
Case Description:
An elderly gentleman with traumatic brain injury underwent DC. He later developed a sinking flap and unexplained agitation which responded to cranioplasty by returning to a state of calm. His cognitive function further improved over a period of 6 months. This is an unusual observation reported in this case.
Conclusion:
Timely recognition of the cognitive complications of craniectomy that may respond to early cranioplasty promises to decrease the length of hospital stay and enhance rehabilitation in such patients.
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