Clin Surg | Volume 5, Issue 1 | Case Report | Open Access

Syndrome of the Trephined: When Bone Becomes the Cure

Caroline Ged1 , Maxime Bretonnier1 , Emmanuelle Samson2 and Laurent Riffaud1,3*

1 Department of Neurosurgery, Pontchaillou University Hospital, France 2 Department of Physical Medicine and Rehabilitation, University of Rennes, France 3 INSERM MediCIS, Unit U1099 LTSI, University of Rennes, France

*Correspondance to: Laurent Riffaud 

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Syndrome of the trephined may develop after decompressive craniectomy: It is an underestimated cause of neurologic deterioration which may appear either a few days or several years after decompressive craniectomy. We report on the case history of a 44-year-old patient who developed a syndrome of the trephined. The patient underwent a large left decompressive hemicraniectomy and evacuation of an acute subdural hematoma after traumatic brain injury. After his transfer to rehabilitation, he developed as a secondary reaction a right hemiplegia, and aphasia. The patient achieved complete recovery from his motor and speech deficits after cranioplasty. We discuss the literature and clinical implications regarding this syndrome which is a treatable complication of decompressive craniectomy. Physicians must be aware of this singularity in order to propose early cranioplasty whenever possible.


Decompressive craniectomy; Sinking skin flap syndrome; Syndrome of the trephined, Traumatic brain injury


Ged C, Bretonnier M, Samson E, Riffaud L. Syndrome of the Trephined: When Bone Becomes the Cure. Clin Surg. 2020; 5: 2994..

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