Síndrome del trefinado / Syndrome of the trephined

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 (AU)

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 (AU)

[Syndrome of the trephined]. / Síndrome del trefinado.

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.

Linfedema facial secundario a enfermedad de morbus Morbihan / Facial lymphedema due to Morbihan disease

El linfedema facial es una patología poco frecuente y suele ser secundario al tratamiento de tumores de cabeza y cuello. La enfermedad de Morbihan es una rara entidad que se caracteriza por la aparición de eritema y edema en el tercio medio y superior de la cara, de consistencia habitualmente dura. Su diagnóstico, valoración y tratamiento es muy complicado. Presentamos el caso de un paciente derivado a consultas de Rehabilitación por edema facial duro y dificultad para apertura ocular. La intervención rehabilitadora junto con el drenaje linfático manual consiguió una mejoría del edema, de la dureza y de la dificultad de la visión, valorado mediante la escala visual analógica. El linfedema facial es una entidad poco frecuente, de difícil valoración y con estudios escasos acerca de su tratamiento. El drenaje linfático manual puede ser una ayuda para mejorar el edema y en consecuencia la calidad de vida de estos pacientes (AU)

Facial lymphedema is an infrequent condition that is often caused by treatment for head and neck cancer. Morbihan disease is a rare entity characterised by the development of erythema and solid oedema in the middle and upper third of the face. The evaluation, diagnosis and treatment of this condition are hugely complicated. We report the case of a male patient who was referred to the rehabilitation department for hard facial oedema and difficulty in opening his eyes. The rehabilitation intervention and manual lymphatic drainage improved the oedema and its consistency, as well as the patient's vision, measured with a visual analogue scale. Facial lymphedema is an unusual entity that is difficult to diagnose. Few studies have been performed of its treatment. Manual lymphatic drainage can be useful to improve the oedema and quality of life of these patients (AU)