Sinking skin flap syndrome is a craniectomy complication characterized by new neurological dysfunction that typically worsens in the upright position and improves after cranioplasty. We present a 33-year-old man who experienced hemiparesis in the upright position after craniectomy. Upright computed tomography (CT) before cranioplasty showed a remarkable shift of the brain compared to supine CT. After cranioplasty, both symptoms and brain shift on CT resolved. Upright CT enables detection and objective evaluation of paradoxical herniation and midline shift that is not obvious on supine imaging modalities. Clinicians need to be aware of positional brain shift in postcraniectomy patients.

下沉性皮瓣综合征是一种颅骨切除术并发症，其特征在于新的神经功能障碍，通常在直立位置加重，颅骨成形术后可改善。我们介绍了一名33岁的男子，在颅骨切除术后直立时出现偏瘫。与仰卧位CT相比，颅骨成形术之前的立式计算机断层扫描（CT）显示大脑发生了显着变化。颅骨成形术后，CT上的症状和脑转移均得到解决。立式CT能够检测和客观评估悖论性疝和中线移位，这在仰卧成像方式上并不明显。临床医生需要意识到颅骨切除术后患者的位置脑移位。