Abstract
We present the case of a 62-year-old man, with a history of severe head injury, right parietal fracture, frontal concussion, right subdural hematoma, and posttraumatic hydrocephalus. Two months later he showed progressive neurologic deterioration with bradypsychia, loss of mobility of the left side
Highlights
The inhibition of function in a portion of the brain at a distance from the original site of injury is known as “diaschisis.” In the presented case, these neurologic deficits may be a consequence of reduced cerebral blood flow[1] and a disturbed metabolism due to direct cortical compression of the sinking cranioplasty and the secondary diaschisis at different levels
The observed changes suggest that there is a hemodynamic problem[2] giving rise to an impaired cerebral metabolism when a sinking cranioplasty affects the cerebral cortex and that it can improve after cranioplasty replacement,[3] which reflects the plasticity of the human brain
Summary
The inhibition of function in a portion of the brain at a distance from the original site of injury is known as “diaschisis.” In the presented case, these neurologic deficits may be a consequence of reduced cerebral blood flow[1] and a disturbed metabolism due to direct cortical compression of the sinking cranioplasty and the secondary diaschisis at different levels (corticocerebellar, thalamic, striatal, and cortical).
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