Posture-dependent recovery from sinking skin flap syndrome: A case report

Abstract

Background: Decompressive craniectomy is performed to treat various neurosurgical conditions involving brain edema that cause a mass effect. However, it may result in sinking skin flap syndrome (SSFS) in some patients, for which cranioplasty is the only treatment option. In some cases, patients with SSFS are unable to undergo immediate cranioplasty because of various risk factors. Here, we present the case of a patient with SSFS temporarily treated with posture modification technique at bedside.Case description.We describe a 53-year-old patient who underwent craniectomy for severe intracerebral hematoma and experienced SSFS. Due to bacterial meningitis, cranioplasty had to be delayed and neurological deficits caused by SSFS were managed by pointing the decompressed side downward. After this treatment, several neurological deficits and computed tomography findings improved. Conclusions: This posture modification technique may be useful to temporarily treat neurological deficits in SSFS until the patient is able to undergo cranioplasty. This non-invasive procedure can be performed by anyone at bedside without any tools.