Presentation
Post-hemicraniectomy for intracranial hemorrhage after head trauma.
Patient Data
Age: 45 years
Gender: Male
From the case:
Sinking skin flap syndrome
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Encephalomalacia in the left temporoparietal region and adjacent ex-vacuo ventriculomegaly as a sequel of cerebral insult associated with large left fronto-parietal craniectomy with the concavity of overlying skin flap.
Case Discussion
Paradoxical brain herniation, also known as sinking skin flap syndrome, is a fatal sequela of decompressive craniectomy that takes several weeks to months to develop.
There are negative gradients between atmospheric and intracranial pressure, aggravated by changes in the CSF compartment following CSF drainage.
This is a reversible condition if diagnosed at the proper time.
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