Decompressive craniectomy is widely recognized as a life-saving emergency operation for the treatment of increased intracranial pressure; however, it can lead to severe complications, such as "syndrome of the trephined." Cerebrospinal fluid diversion, particularly after lumboperitoneal shunting, can affect the occurrence of this disease and worsen the symptoms. We report an acute case of this syndrome after lumboperitoneal shunting in a patient who had previously undergone decompressive craniectomy. The patient rapidly fell from a Glasgow Coma Scale (GCS) of 14 to a comatose state and a GCS of 4 only in 2 days. After cranioplasty, the patient recovered fully; however, this took a prolonged period.
Keywords: Cerebrospinal fluid shunt; Craniotomy; Decompressive craniectomy; Hydrocephalus; Intracranial hypotension.
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