Post-Surgery Complications After Intracranial Hemorrhage: What to Watch For

Post-operative complications after surgery for intracerebral hemorrhage?

I apologize for bothering you, doctor.
My father fell from a height last August and suffered fractures on both sides of his skull, along with intracranial hemorrhage.
He underwent surgery and was discharged around early October after the skull was replaced.
However, since his discharge, he has been experiencing persistent headaches.
In November, he returned to the hospital for a CT scan, which showed no significant issues, and the doctor mentioned it might just be residual effects.
Recently, in addition to the headaches, he has been experiencing itching on his scalp, especially near the surgical site, to the point where he has caused injuries from scratching.
Should he return to the hospital for a check-up with a dermatologist or a neurosurgeon? Additionally, what symptoms should we be particularly cautious about in patients who have undergone surgery for intracranial hemorrhage? Thank you for your response, doctor.

Yuwen, 30~39 year old female. Ask Date: 2017/07/06

Dr. Zhang Junwei reply Neurosurgery

If you have an itchy scalp, please see a dermatologist.
There isn't much to be particularly concerned about; however, if you notice anything unusual or different about the patient, follow up with a neurosurgery clinic for monitoring.

Reply Date: 2017/07/06

More Info

Post-surgery complications after intracranial hemorrhage can be quite complex and require careful monitoring. Your father's situation, following his fall and subsequent surgery for skull fractures and intracranial bleeding, is not uncommon. After such significant trauma and surgical intervention, patients may experience a range of symptoms, some of which may be concerning.

Firstly, it’s important to understand that headaches are a common post-operative symptom. They can be attributed to several factors, including tension, changes in intracranial pressure, or even the healing process itself. However, persistent or worsening headaches should always be evaluated, especially if they are accompanied by other symptoms.

The itching of the scalp near the surgical site that your father is experiencing could be related to several factors. It may be a reaction to the surgical incision, the healing process, or even the materials used during the surgery (such as sutures or staples). If he is scratching the area and causing injury, this could lead to infection or delayed healing. In this case, it would be advisable to consult a dermatologist to assess the scalp condition and provide appropriate treatment. They can help determine if there is an underlying skin condition or if the itching is simply a part of the healing process.

In terms of symptoms to watch for after surgery for intracranial hemorrhage, there are several key indicators that should prompt immediate medical attention:
1. Worsening Headaches: If the headaches become more severe or change in character, it could indicate complications such as increased intracranial pressure or rebleeding.

2. Neurological Changes: Any new or worsening neurological symptoms, such as confusion, difficulty speaking, weakness in limbs, or changes in vision, should be taken seriously.

3. Seizures: The occurrence of seizures post-surgery can indicate irritation of the brain tissue and may require further evaluation and management.

4. Fever or Signs of Infection: A fever, especially if accompanied by redness, swelling, or discharge at the surgical site, could suggest an infection that needs prompt treatment.

5. Changes in Consciousness: Any significant changes in alertness or responsiveness should be evaluated immediately.

6. Cerebrospinal Fluid Leakage: Clear fluid draining from the surgical site could indicate a leak of cerebrospinal fluid, which may require intervention.

7. Mood Changes or Behavioral Changes: Post-surgery, some patients may experience changes in mood or behavior, which could be related to the brain injury or the effects of medications.

In summary, while some symptoms like headaches and itching may be common after such surgeries, it is crucial to remain vigilant for any signs that could indicate complications. Regular follow-up appointments with the neurosurgeon are essential, and if new symptoms arise, do not hesitate to seek immediate medical advice. Your father's well-being is paramount, and addressing any concerns early can lead to better outcomes.

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