Post-Surgery Numbness and Hardness in Left Forehead: Is It Normal?

After the surgery for the lipoma on the left forehead, I feel a hardness and numbness in the upper left side of my head?

Hello Doctor, I underwent an endoscopic tumor excision surgery for a lipoma on the left side of my forehead on March 17, 2017.
On the day of the surgery, I felt a tingling and numb sensation on the left side of my head, which I attributed to the anesthesia.
However, by my follow-up appointment on March 22, 2017, I felt that something was not quite right and reported it to the hospital.
I was told, "We only operated on the forehead and did not touch the back," and was advised to observe further.

Now, on March 25, 2017, it has been a week, and the area on the left side of my brain, towards the forehead, still feels numb and tight.
Is this situation normal? Additionally, the endoscopic tumor excision was performed by the hospital's cosmetic surgery department, and there were no special X-rays or examinations conducted prior to the surgery.
Even during my follow-up, I was not asked to undergo any brain imaging or ultrasound.
Is this normal?
I am concerned that there may have been nerve damage during the surgery, or that the anesthesia has not completely worn off.
Should I make an appointment with a neurologist or a neurosurgeon for further evaluation? I hope to receive a prompt response to guide me on what steps I should take.
Thank you very much.

Jing Mei, 40~49 year old female. Ask Date: 2017/03/25

Dr. Jiang Junyi reply Neurology

Hello, you mentioned that neuropathic pain differs from the pain associated with general tissue injury, including sensations such as tingling, stabbing, burning, coldness, numbness, and itching, which may sometimes be accompanied by varying degrees of sensory abnormalities.
The key to diagnosing radiculopathy lies in clinical examination and medical history; standard X-rays do not reveal the fine nerves, and even specialized imaging studies can be quite challenging to visualize these nerves.
If there are related concerns, it is advisable to consult a neurosurgeon at the same hospital to discuss examinations and treatments, which can help clarify the medical history and surgical options (considering the possibility of cervical degeneration causing nerve root compression).
Wishing you good health and peace.

Reply Date: 2017/03/25

More Info

Post-surgery numbness and hardness in the forehead area, especially after a procedure like an endoscopic tumor removal, can be concerning for patients. It’s important to understand that some degree of numbness or altered sensation can be a common occurrence following surgery, particularly in areas where nerves may have been manipulated or affected during the procedure.

In your case, the numbness and sensation of tightness in the left forehead area could be attributed to several factors:
1. Nerve Trauma: During surgery, even minimally invasive techniques like endoscopy can inadvertently affect nearby nerves. If the sensory nerves in the forehead area were stretched or compressed during the procedure, this could lead to temporary numbness or altered sensations. This is often referred to as neuropraxia, which is a temporary loss of function due to nerve compression or injury.

2. Swelling and Inflammation: Post-operative swelling is a normal response to surgery. This swelling can put pressure on surrounding tissues and nerves, leading to sensations of numbness or tightness. As the swelling subsides, these sensations typically improve.

3. Anesthesia Effects: Local anesthesia can cause temporary numbness in the area where it was administered. While this typically resolves within a few hours to a couple of days, some patients may experience lingering effects, especially if the anesthesia was injected near a nerve.

4. Healing Process: The healing process itself can lead to changes in sensation. As tissues heal, they may regenerate in a way that temporarily alters how sensations are perceived.

Given that you are experiencing persistent numbness and tightness a week after surgery, it is advisable to follow up with your healthcare provider. Here are some steps you can take:
- Consult Your Surgeon: Since the surgery was performed by a plastic surgery department, it would be appropriate to return to them for a follow-up. They can assess your symptoms and determine if they are within the expected range of post-operative recovery.

- Neurological Evaluation: If your symptoms do not improve or if you experience additional symptoms such as pain, weakness, or changes in vision, it may be prudent to consult a neurologist. They can perform a thorough evaluation to rule out any nerve damage or other complications.

- Imaging Studies: While not always necessary, if there is concern about nerve injury or other complications, your doctor may recommend imaging studies such as an MRI or CT scan to assess the area.

In summary, while some numbness and altered sensation can be normal after surgery, persistent symptoms warrant further evaluation. It’s essential to communicate openly with your healthcare providers about your concerns and symptoms to ensure appropriate care and peace of mind. Remember that recovery can vary significantly from person to person, and your healthcare team is best equipped to guide you through this process.

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