ArticleJournal of surgical case reports2020
Sinking skin flap syndrome in the multi-trauma patient: a paradoxical management to TBI post craniectomy.
Article in Journal of surgical case reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Syndrome of the trephined: from pathophysiology to cranioplasty - an updated narrative review.Brain & spine · 2026Review
- Paradoxical Brain Herniation after Cranioplasty: Secondary Sunken Flap Syndrome.Journal of neurosciences in rural practice · 2022Article
- Sinking skin flap syndrome in a patient with bone resorption after cranioplasty and ventriculoperitoneal shunt placement: illustrative case.Journal of neurosurgery. Case lessons · 2021Article
- Intracranial Compliance Assessed by Intracranial Pressure Pulse Waveform.Brain sciences · 2021Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sinking skin flap syndrome is a rare syndrome leading to increased intracranial pressure, known to neurosurgeons, yet uncommon and hardly ever reported in trauma patients. In a hospitalized trauma patient with declining neurological status, rarely do we encounter further deterioration by elevating the patients' head, diuresis and hyperventilation. However, after craniectomy for trauma, a partially boneless cranium may be compressed by the higher atmospheric pressure, that intracranial pressure rises to dangerous levels. For such cases, paradoxical supportive management with intravenous fluid infusion, and reverse Trendelenburg positioning, is used to counteract the higher atmospheric pressure, as a bridge to definitive treatment with cranioplasty. These steps constitute an urgent and easily applied intervention to reduce further neurological deterioration, of which every trauma healthcare provider should be aware.
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Registered trials
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