Hi! When completing the case-based questions there is one case that focuses on the Syndrome of the Trephined. I have worked with multiple patients post- hemicraniectomy who, as swelling improves, have a sunken skull flap. Would you only be concerned for syndrome of the trephined if there is a sunken skull in the presence of symptoms/worsening mental status and motor functioning? Also, is this a medical emergency that would require immediate positioning in Trendelenburg? Thank you!
That first article also contains some information about the importance of prompt treatment, as the “window of opportunity” closes fairly quickly with less neurologic improvement with increased time to cranioplasty.