Transient ischemic attack post craniectomy: A case report and review of sinking skin flap syndrome

There is evidence of disrupted cerebral blood flow in patients with a skull defect due to decompressive craniectomy though the pathophysiologic mechanism is yet to be established. Here we report on a patient who suffered one episode of transient ischemic attack (TIA) when developing early stage sinking skin flap syndrome (SSFS) post decompressive craniectomy due to a severe traumatic brain injury. This case report of TIA as a clinical presentation of SSFS indicates a potentially increased risk of stroke in patients with this condition. The theories of the pathophysiology underlining neurological manifestations post craniectomy are reviewed. Early cranioplasty is recommended, particularly for those with other known stroke risk factors.