Negative-pressure helmet restores cerebral hemodynamic parameters in sinking skin flap syndrome: a case report

Watchi Michael; Quintard Hervé; Bijlenga Philippe; Pugin Jérôme; Negro Tommaso Rochat

doi:10.18700/jnc.220072

Negative-pressure helmet restores cerebral hemodynamic parameters in sinking skin flap syndrome: a case report

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Type: Academic journal

Author: Watchi Michael Quintard Hervé Bijlenga Philippe Pugin Jérôme Negro Tommaso Rochat

Journal: 대한신경집중치료학회 Journal of Neurocritical Care Journal of Neurocritical Care Vol.15 No.2 KCI Accredited Journals

Published: 2022.12

Pages: 126 - 130 (5page)

DOI: 10.18700/jnc.220072

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Negative-pressure helmet restores cerebral hemodynamic parameters in sinking skin flap syndrome: a case report

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Background: Sinking skin flap syndrome (SSFS) is a rare complication of decompressive craniectomy (DC) and causes a wide range of neurological deficits. Its pathophysiology remains debatable, however cranioplasty may decrease the symptoms of SSFS by reducing the direct effect of atmospheric pressure on the brain and allowing the correction of cerebral blood flow (CBF) and cerebral metabolism.Case Report: A 36-year-old woman underwent DC for a right frontal hematoma and signs of increased intracranial pressure following the resection of a right frontal arteriovenous malformation. Subsequently, she developed SSFS, altered neurological status with a Glasgow Coma Scale (GCS) score of 8/15, and bacterial-resistant meningitis. We applied a custom-shaped negative pressure helmet on the bone defect and used invasive and noninvasive techniques to measure the changes in intracranial pressure, CBF and cerebral oxygen saturation. Despite improvements in the cerebral physiological parameters, the neurological status did not improve (GCS score, 8/15).Conclusions: To our knowledge, this is the first reported case of SSFS treated with a negative-pressure helmet and subsequent changes in cerebral parameters that were monitored invasively and noninvasively.

#Cerebral blood flow #Critical care #Near-infrared spectroscopy #Decompressive craniectomy

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