Seeing It First: How Recognizing Sinking Flap Syndrome Can Change Patient Outcomes

In this AJNR Article Summary, Dr. George Vilanilam discusses the article, "Sinking Flap Syndrome: Risk Factors, Outcomes, and the Role of Neuroradiology in Cranioplasty Timing." Sinking flap syndrome is a common yet frequently underrecognized complication of decompressive craniectomy, with imaging findings often preceding clinical deterioration. Recognition and reporting of key features - including a markedly sunken flap, ventricular compression, and significant midline shift (8 mm or greater) were associated with a two-fold reduction in time to cranioplasty highlighting the important role neuroradiologists can play in expediting definitive treatment and improving patient care.