title: Unusual presentation of the "syndrome of the trephined".
abstract: A 45-year-old lady underwent right fronto-parietal craniotomy and subtotal excision of a parasagittal meningioma. Bone flap was not replaced as it was infiltrated by the tumor. In the postoperative period she developed episodes of altered sensorium associated with worsening of left hemiparesis and a sunken scalp at the site of bone defect. Computed tomography (CT) of brain showed sunken scalp flap in the right fronto-parietal region with compression of the underlying brain. A diagnosis of syndrome of the trephined was considered and her symptoms improved with cranioplasty. Pathophysiology of the syndrome of the trephined is discussed.
authors.affiliation: Department of Neurological Sciences, Christian Medical College and Hospital, Vellore - 632 004, India.
authors.forename: G Samson Sujit
authors.initials: GS
authors.lastname: Kumar
authors.forename: Ari G
authors.initials: AG
authors.lastname: Chacko
authors.forename: Vedantam
authors.initials: V
authors.lastname: Rajshekhar
mesh_terms: D005260:Female; D006801:Humans; D008875:Middle Aged; D019635:Neurosurgical Procedures; D010291:Paresis / Q000209:etiology; D012678:Sensation Disorders / Q000209:etiology; D012886:Skull / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed