Sinking Skin Flap Syndrome after Craniectomy in a Patient Who Previously Underwent Ventriculoperitoneal Shunt / 대한신경손상학회지

ABSTRACT

Sinking skin flap syndrome, resulting from decompressive craniectomy, is defined as a series of neurologic symptoms with skin depression at the site of cranial defect. A 61-year-old male was hospitalized with high fever and operative site swelling. He underwent decompressive craniectomy on his left side for treatment for acute subdural hematoma and traumatic intracerebral hematoma 5 years ago. Four months later, a ventriculoperitoneal shunt was performed for treatment for hydrocephalus and cranioplasty was also performed. We suspected infection at the previous operative site and proceeded with craniectomy and epidural abscess removal. Following the procedure, the depression of the sinking flap became significant, and he has suffered from right hemiparesis. We performed a shunt catheter tie at the level of the right clavicle under local anesthesia, and the patient recovered his health to his baseline. We present a patient who was successfully managed with a tie of the shunt catheter for sinking skin flap syndrome.