Abstract
Sinking flap syndrome (SFS), a rare complication of decompressive craniectomy, can lead to significant neurological deterioration due to atmospheric pressure changes. Here, we present the case of an 81-year-old male with chronic subdural hematoma who developed SFS post-craniectomy. Initial surgeries involved mini-craniectomy and hemicraniectomy due to acute hematoma complications. The patient experienced progressive neurological deficits, prompting cranioplasty. Following cranioplasty, the patient showed rapid neurological improvement, with resolution of hemiparesis and improved consciousness. Postoperative imaging confirmed stabilization of intracranial dynamics and no new bleeding.