Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Aug;11(4):e561-e563.
doi: 10.1212/CPJ.0000000000000859.

Neurologic Deterioration in Sinking Skin Flap Syndrome After Diuretic Therapy

Cristina Boccagni  1 , Sergio Bagnato  1 , Valerio Alaimo  1 , Giuseppe Galardi  1
Affiliations
Case Reports

Neurologic Deterioration in Sinking Skin Flap Syndrome After Diuretic Therapy

Cristina Boccagni et al. Neurol Clin Pract. 2021 Aug.
No abstract available

PubMed Disclaimer

Figures

Figure
Figure. CT and MRI Scans Before, During, and After Ending Diuretic Therapy Show Development and Disappearance of Paradoxical Brain Herniation
(A and B) A CT scan 48 days after the trauma (before starting diuretic therapy) showed no signs of hemispheric dislocation and brainstem compression. (C and D) A CT scan 56 days after the trauma (while taking diuretic therapy) showed a concave appearance of the left cerebral hemisphere with a shift of the midline structures (C) and sign of initial left uncal herniation (D) (red arrows). (E and F) A MRI T1 scan 69 days after the trauma showed a clear improvement in the shift of the midline structures (E) after the reduction of diuretic therapy and no more signs of uncal herniation (F).
See this image and copyright information in PMC

References

    1. Grant FC, Norcross NC. Repair of cranial defects by cranioplasty. Ann Surg 1939;110:488–512. - PMC - PubMed
    1. Annan M, De Toffol B, Hommet C, Mondon K. Sinking skin flap syndrome (or syndrome of the trephined): a review. Br J Neurosurg 2015;29:314–318. - PubMed
    1. Akins PT, Guppy KH. Sinking skin flaps, paradoxical herniation, and external brain tamponade: a review of decompressive craniectomy management. Neurocrit Care 2008;9:269–276. - PubMed
    1. Ji H, Chen W, Yang X, et al. . Paradoxical herniation after unilateral decompressive craniectomy: a retrospective analysis of clinical characteristics and effectiveness of therapeutic measures. Turk Neurosurg 2017;27:192–200. - PubMed

Publication types