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What Are The Chances Of A Nerve Damage Post A Brain Surgery?
Question: I had brain surgery 6 years ago and have had knots under the skin on the right side of my head (same side where the incision was made). I understand there is some nerve damage but these knots end up opening and then I have open sores. As they heal, others pop open. I've seen 5 different types of doctors and no one can figure it out. This has been going on for 6 yeas, since the operation.Do you have any suggestion?
Brief Answer:
Cause of discharge from scar and management
Detailed Answer:
Hi Beniouise, thanks for asking from HCM.
I can understand your concern. You have an old scar at surgery site. As per your history, it has the tendency to form knots and then burst-discharge from it. This problem happens mainly due to two reasons
- Foreign body at surgical site - During brain surgery, we use cotton, sutures, metallic instruments. Sometimes a piece of them may be left at operative site and it may go un-noticed. This acts as foreign body. The foreign body has a tendency to generate inflammatory reaction and it leads to sero-sanguinous or pus collection. This collection leads to knot formation and then burst-discharge phenomenon.
The inflammation is mild and slow process. So it takes some time to form knots again.
- Chronic infection - Chronic infection is a slow, persistent and mild infection which can occur in bone (the skull bone), collection (blood/CSF collected at surgery site), around foreign body (Inside sutures/miniplates/burrhole cover). This chronic infection manifests similar to foreign body reaction and usually resistant to antibiotics. It responds to surgical curettage and cleaning.
Now coming to your complaints, you have already discussed many doctors. If anybody has advised you about this, do let me know? Did anybody advise CT head and if yes, what was the finding?
These answers are needed to make diagnosis and plan treatment.
For treatment of your intermittent discharge, there is need to explore the wound site. It must be planned after reading CT report. It should be explored by the first surgeon or the experienced one, who can explore it with eagle eye. Any foreign body must be removed and infected bone or scalp tissue must be excised. After this, thorough cleaning will prevent recurrence of discharge. Role of antibiotics is only after removal of infected tissue and foreign body (If present any). Also the pus and infected tissue must be sent for biopsy and culture to know the infection type. Sometimes fungal infection or skin cancer might be the cause. There management is different.
Hope it will help. If still in doubt, do let me know.
Thanks. Take care.
Cause of discharge from scar and management
Detailed Answer:
Hi Beniouise, thanks for asking from HCM.
I can understand your concern. You have an old scar at surgery site. As per your history, it has the tendency to form knots and then burst-discharge from it. This problem happens mainly due to two reasons
- Foreign body at surgical site - During brain surgery, we use cotton, sutures, metallic instruments. Sometimes a piece of them may be left at operative site and it may go un-noticed. This acts as foreign body. The foreign body has a tendency to generate inflammatory reaction and it leads to sero-sanguinous or pus collection. This collection leads to knot formation and then burst-discharge phenomenon.
The inflammation is mild and slow process. So it takes some time to form knots again.
- Chronic infection - Chronic infection is a slow, persistent and mild infection which can occur in bone (the skull bone), collection (blood/CSF collected at surgery site), around foreign body (Inside sutures/miniplates/burrhole cover). This chronic infection manifests similar to foreign body reaction and usually resistant to antibiotics. It responds to surgical curettage and cleaning.
Now coming to your complaints, you have already discussed many doctors. If anybody has advised you about this, do let me know? Did anybody advise CT head and if yes, what was the finding?
These answers are needed to make diagnosis and plan treatment.
For treatment of your intermittent discharge, there is need to explore the wound site. It must be planned after reading CT report. It should be explored by the first surgeon or the experienced one, who can explore it with eagle eye. Any foreign body must be removed and infected bone or scalp tissue must be excised. After this, thorough cleaning will prevent recurrence of discharge. Role of antibiotics is only after removal of infected tissue and foreign body (If present any). Also the pus and infected tissue must be sent for biopsy and culture to know the infection type. Sometimes fungal infection or skin cancer might be the cause. There management is different.
Hope it will help. If still in doubt, do let me know.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Remy Koshy
Answered by
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