Syndrome of the trephined: theory and facts.

The pathophysiology behind "the syndrome of the trephined" has been under investigation over the past 50 years. Research related to barometric pressure, cellular metabolism, cerebrospinal fluid (CSF) dynamics, and the vasculature have attempted to decipher the mechanism of disease. These subjects are discussed in five papers along with specific topics related to the syndrome. The symptoms experienced after craniectomy, the resolution of symptoms with cranioplasty as well as CSF, cerebral blood flow, and metabolic studies are presented, respectively, with a review of the theories.