Elimination of recurrent post-necrotic skin defect with titanium implant in the left frontal-temporal-parietal brain lobes using combined expansion of tissues while neuro-rehabilitation of a female patient with prolonged post-coma consciousness disorders

Olexander V. Kulyk, Volodymyr G. Ushakov, Ruslan M. Pidhayetskyy, Oleksandr V. Borzykh, Sergiy Y. Krysko, Arthur O. Mumlev


Elimination of severe syndrome of the treponated with meteorological dependence and drug-resistant symptomatic epilepsy after decompressive hemicraniectomy in patients with severe acute hypoxic brain lesions (vegetative status) is a valid clinical statement for early neurorehabilitation, and an important pre-condition for achieving higher levels of consciousness in terms up to 6 months after patients’ coming out of coma. Skull bones extensive defects substitution with titanium mesh implant requires surgical tactics clear planning and prevention of unlikely complications such as skin necrosis above the implant.

The clinical case of long-term (within 2 years) renewing treatment and neurorehabilitation in a patient in vegetative state caused by brain severe hypoxia after meningioma partial removal in a region of the sella turcica diaphragm and left posterior oblique process is described. Innovative techniques of tissue expansion let us decrease surgical complications, postnecrotic defect of the soft tissue, severity of neurological deficit and to achieve maximum of patient’s consciousness possible recovery.


defect of the head soft tissues; necrosis of displaced skin flap; repeated plastic; tissue expansion; syndrome of the trephined; neurorehabilitation


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