Unusual presentation in syndrome of trephined - A unique case observation

Hafiza Fatima Aziz, Muhammad Waqas Saeed Baqai, Rashid Jooma

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Article numberA62
JournalSurgical Neurology International
Publication statusPublished - 2022


  • Cognitive dysfunction
  • Cranioplasty
  • Decompressive craniectomy
  • Sinking flap syndrome
  • Syndrome of trephined


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