A Case of “Sinking Skin Flap Syndrome” in Vegetative State Patient

Abstract

Sinking skin flap syndrome is defined by a series of neurological symptoms with skin depression at the site of cranial defect. We experienced neurological improvement in a patient with markedly sunken craniectomy site after ventriculoperitoneal shunt (V-P shunt) clamping operation. A 17-year old female patient was in vegetative state and spastic quadriplegia after traumatic brain injury. She was suffered from frequent vomiting. To evaluate central nervous system problem we checked brain computed tomography which showed that right frontotemporoparietal craniectomy area was markedly sunken and midline was shifting to the left. After V-P shunt clamping operation, craniectomy site was elevated and midline shifting was improved. Vomiting was disappeared. Coma Recovery Scale-revised (CRS-R) score was improved from 3 to 6.

Acute Onset of Syndrome of the Trephined After Lumboperitoneal Shunt Placement: A Case Report

“…In those cases, CSF diversion procedure, either of V-P shunt or CSF drainage through lumbar spinal puncture were performed during rehabilitation period when the patient was in stable status so it is able to detect onset time, symptom progress and recovery. 3 4 6 7 9 10 13 14 15) …”