Syndrome of the Trephined (SoT) is a severe complication following decompressive craniectomy. Urgent cranioplasty fully reverses the neurologic symptoms of SoT. This article presents a recent case of SoT following inflation of a scalp tissue expander.
A review of the literature was performed and case details obtained from the electronic medical record. Our patient had a large craniectomy defect following traumatic brain injury. A scalp tissue expander was used before secondary cranioplasty. The patient suffered severe neurologic decline temporally related to tissue expander inflation, which was fully reversed following expander removal and urgent cranioplasty.
SoT can be a neurologically devastating complication which can resolve following urgent cranioplasty. To our knowledge, this is the first description of SoT resulting from inflation of a scalp tissue expander. Familiarity with this syndrome is critical for the plastic surgery provider, who may be called upon to assist with these urgent cases.
Address correspondence and reprint requests to Peter W. Thompson, MD, Emory University School of Medicine, Atlanta, GA 30322; E-mail: pwthomp@emory.edu
Received 13 June, 2020
Accepted 23 August, 2020
Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
Investigation performed at the Emory Clinic, Atlanta, Georgia
The authors report no conflicts of interest.
© 2020 by Mutaz B. Habal, MD.
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