"Syndrome of the Sinking Skin-Flap" Secondary to the Ventriculoperitoneal Shunt after Craniectomy

Han, Pan; Kim, Jae-Hoon; Kang, Hee In; Kim, Joo Seung

doi:10.3340/jkns.2008.43.1.51

Cited by 43 publications

(39 citation statements)

References 13 publications

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“…First, expanding the concave space at the skull defect may be an effective way to eliminate the dead space between the skull plate and the dura to facilitate the cranioplasty, which makes the tight adhesion of titanium mesh and dura compassable. Liao et al reported 4 cases getting favourable prognosis by clipping of the shunt tube provisionally and doing operation after the expansion of the depressed scalp [6]. Second, the operation details are also crucial for the clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, most of them require CSF shunting treatment [2]. After this procedure, the bulging craniectomy area may become extremely depressed after shunting due to the decrease in ventricular size [3,6]. And it may increase the risk of complications such as intracranial hematoma and subdural effusion when doing a cranioplasty subsequently [3].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cerebral Hernia Caused By Epidural Hygroma Due to Excessive Drainage of Cerebrospinal Fluid: A Rare Case and Literature Review

Wang¹,

Ma²,

Guan³

et al. 2017

J Neurol Disord

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cerebral Hernia Caused By Epidural Hygroma Due to Excessive Drainage of Cerebrospinal Fluid: A Rare Case and Literature Review

Wang¹,

Ma²,

Guan³

et al. 2017

J Neurol Disord

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“…To date, there are few case reports in the literature. Correction of the sunken scalp improves the neurological deterioration 1 2. In all cases, SSFS developed after decompressive craniectomy and the sunken skin compressed the underlying cerebral cortex.…”

Section: Introductionmentioning

confidence: 95%

Sinking skin flap syndrome in glioblastoma

Kamiya-Matsuoka¹,

Shroff²,

Tatsui³

et al. 2014

BMJ Case Reports

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SUMMARYSinking skin flap syndrome (SSFS) is a rare neurological complication in patients with traumatic haemorrhage, stroke or cerebral oedema who undergo decompressive craniectomy to relieve increased intracranial pressure. Hallmark of SSFS is the sinking of the scalp to a plane lower than the edges of the skull defect in the setting of neurological deterioration. Our objective is to report that SSFS can present after small craniotomy without cerebral cortex compression and to share our diagnostic/ therapeutic approach. A 62-year-old woman with a glioblastoma developed SSFS after a small craniectomy and tumour resection without cerebral cortex compression but a decrease in the surgical cavity volume. Brain MRI showed decreased size of the surgical cavity. Interestingly, the patient also developed posterior reversible encephalopathy syndrome (PRES).This case highlights an atypical presentation of SSFS and the possible association with PRES. It also illustrates how an early cranioplasty can successfully reverse SSFS. BACKGROUND

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“…[22] Apart from their potential use as biomolecule delivery vehicles, bioactive scaffolds may also be used to assist in the regeneration of the cranium [23,24], which is important for preventing neurological deterioration and significant depression after PBI. [25,26] For this purpose, we have developed PCL/tricalcium phosphate (PCL/TCP) scaffolds that are capable of promoting bone regeneration. [27][28][29] In addition, our previous report suggested that PCL/TCP scaffolds have reduced inflammation as compared to PCL scaffolds, possibly due to the localized increase in pH to combat clinical acidosis.…”

Section: Introductionmentioning

confidence: 99%

Effects of Polycaprolactone-Based Scaffolds on the Blood–Brain Barrier and Cerebral Inflammation

Nga

Lim

Choy

et al. 2015

Tissue Engineering Part A

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Severe pathoanatomical and mechanical injuries compromise patient recovery and survival following penetrating brain injury (PBI). The realization that the blood-brain barrier (BBB) plays a major role in dictating post-PBI events has led to rising interests in possible therapeutic interventions through the BBB. Recently, the choroid plexus has also been suggested as a potential therapeutic target. The use of biocompatible scaffolds for the delivery of therapeutic agents, but little is known about their interaction with cerebral tissue, which has important clinical implications. Therefore, the authors have sought to investigate the effect of polycaprolactone (PCL) and PCL/tricalcium phosphate (PCL/TCP) scaffolds on the maintenance of BBB phenotype posttraumatic brain injury. Cranial defects of 3 mm depth were created in Sprague Dawley rats, and PCL and PCL/TCP scaffolds were subsequently implanted in predetermined locations for a period of 1 week and 1 month. Higher endothelial barrier antigen (EBA) expressions from PCL-based scaffold groups (p>0.05) were found, suggesting slight advantages over the sham group (no scaffold implantation). PCL/TCP scaffold group also expressed EBA to a higher degree (p>0.05) than PCL scaffolds. Importantly, higher capillary count and area as early as 1 week postimplantation suggested lowered ischemia from the PCL/TCP scaffold group as compared with PCL and sham. Evaluation of interlukin-1β expression suggested that the PCL and PCL/TCP scaffolds did not cause prolonged inflammation. BBB transport selectivity was evaluated by the expression of aquaporin-4 (AQP-4). Attenuated expression of AQP-4 in the PCL/TCP group (p<0.05) suggested that PCL/TCP scaffolds altered BBB selectivity to a lower degree as compared with sham and PCL groups, pointing to potential clinical implications in reducing cerebral edema. Taken together, the responses of PCL-based scaffolds with brain tissue suggested safety, and encourages further preclinical evaluation in PBI management with these scaffolds.

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"Syndrome of the Sinking Skin-Flap" Secondary to the Ventriculoperitoneal Shunt after Craniectomy

Cited by 43 publications

References 13 publications

Cerebral Hernia Caused By Epidural Hygroma Due to Excessive Drainage of Cerebrospinal Fluid: A Rare Case and Literature Review

Cerebral Hernia Caused By Epidural Hygroma Due to Excessive Drainage of Cerebrospinal Fluid: A Rare Case and Literature Review

Sinking skin flap syndrome in glioblastoma

Effects of Polycaprolactone-Based Scaffolds on the Blood–Brain Barrier and Cerebral Inflammation

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