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Vol. 55. Issue 4.
Pages 325-328 (October - December 2021)
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Vol. 55. Issue 4.
Pages 325-328 (October - December 2021)
Caso clínico
Síndrome del trefinado
Syndrome of the trephined
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...
I. Martínez-Viñuelaa,
Corresponding author
irenemmv@hotmail.com

Autor para correspondencia.
, I. Paredes-Borracherob, M. Rubio-Melladoa, L. Fernández-Garcíaa, J. Madrid-Sáncheza, M. García-Basconesa, M. Díaz-Jiméneza
a Servicio de Medicina Física y Rehabilitación, Complejo Hospitalario de Toledo, Toledo, España
b Unidad de Cuidados Intensivos, Complejo Hospitalario de Toledo, Toledo, España
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Resumen

El síndrome del trefinado (ST) consiste en el deterioro neurológico que se produce tras la realización de una craniectomía descompresiva en la que no se lleva a cabo reposición ósea. Su incidencia es variable, aunque se cree que esta entidad está infradiagnosticada. Se caracteriza por la reversión de los síntomas tras dicha reposición del hueso, por lo que este es el único tratamiento definitivo.

Mostramos el caso de un paciente valorado por el servicio de rehabilitación en la unidad de cuidados intensivos tras sufrir un accidente cerebrovascular, que presenta alteración del nivel de consciencia y deterioro motor abrupto, siendo diagnosticado de ST. La intervención rehabilitadora, con cambios posturales precoces del paciente ayudó a mitigar los síntomas hasta que se realizó el tratamiento resolutivo final.

Palabras clave:
Craniectomía descompresiva
Síndrome del trefinado
Rehabilitación
Cambios posturales
Abstract

Syndrome of the trephined (SoT) is the neurological deterioration that occurs after the performance of decompressive craniectomy in which bone is not replaced. The incidence of SoT varies, but this entity seems to be underdiagnosed. It is characterized by symptom reversal after bone replacement, which is the only definitive treatment.

We report the case of a patient assessed by the Rehabilitation Service in the Critical Care Unit after a stroke, who had altered level of consciousness and abrupt motor impairment. The patient was diagnosed with SoT. Rehabilitation, with early postural changes, helped to ameliorate the symptoms until the provision of definitive treatment.

Keywords:
Decompressive craniectomy
Syndrome of trephined
Rehabilitation
Postural changes

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