• Nathan Beucler and Arnaud Dagain.
• Neurosurgery Department, Sainte-Anne Military Teaching Hospital, Toulon, France; Ecole du Val-de-Grâce, French Military Health Service Academy, Paris, France. Electronic address: nathan.beucler@neurochirurgie.fr.
• World Neurosurg. 2022 Jun 1; 162: 11-14.

AbstractDecompressive craniectomy has been adopted as a possible therapeutic option for extreme cases of traumatic brain injury and malignant ischemic stroke. The history of decompressive craniectomy, though, involves civilian and military discoveries that have been progressively confused and even forgotten. The syndrome of the trephined was introduced in 1939 as a feeling of tenderness, discomfort, and insecurity located at the site of craniectomy. Forty years later, in 1977, the sinking skin flap syndrome was defined as new-onset neurologic deficits or even coma associated with marked skin depression at the site of craniectomy, indicating urgent need for cranioplasty. These 2 syndromes illustrate the paradigm shift of the indications for cranioplasty, which have evolved from cosmetic reasons in the 1940s to cerebral metabolism improvement in the early 21st century.Copyright © 2022 Elsevier Inc. All rights reserved.

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