Aziz Hafiza Fatima, Baqai Muhammad Waqas Saeed, Jooma Rashid
Department of Neurosurgery, The Aga Khan University Hospital, Karachi, Pakistan.
Surg Neurol Int. 2022 Dec 2;13:562. doi: 10.25259/SNI_988_2022. eCollection 2022.
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.
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.
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.
环锯术综合征（SoT）是减压性颅骨切除术（DC）一种公认的并发症。随着DC在治疗严重颅内压升高方面的应用增加，近年来对SoT的认识有所提高。它通常在数周或数月后出现一系列不良神经症状，最常见的是肌力恶化。
一位患有创伤性脑损伤的老年男性接受了DC。他后来出现了颅骨瓣下陷和不明原因的躁动，通过颅骨成形术恢复平静状态后症状得到缓解。他的认知功能在6个月内进一步改善。这是该病例中报告的一个不寻常发现。
及时识别可能对早期颅骨成形术有反应的颅骨切除术认知并发症，有望缩短此类患者的住院时间并加强康复。
