Post-Craniectomy Skull Deformity: When to Seek Urgent Care?

Abnormalities of the cranial vault after craniotomy?

After the craniotomy on November 17, 2020, the recovery has been relatively good, but recently I have noticed some deformation of the skull, with noticeable irregularities at the surgical incision site.
Should I seek an urgent follow-up appointment, or can I wait for the scheduled follow-up in two months to get a CT scan?

SHIJ, 30~39 year old female. Ask Date: 2021/09/28

Dr. Zhang Junwei reply Neurosurgery

If there is no redness, swelling, heat, or pain, you may return for a follow-up appointment regularly.

Reply Date: 2021/09/28

More Info

Post-craniectomy skull deformity can be a concerning issue, especially after a significant surgical procedure like a craniectomy. It is essential to monitor any changes in the skull's shape and the overall condition of the patient. In your case, since you have noticed a noticeable deformity at the surgical site, it is crucial to evaluate the situation carefully.

Firstly, it is important to understand that some degree of skull deformity can occur after a craniectomy due to the removal of a portion of the skull. This can lead to changes in the contour of the skull, and in some cases, it may be a normal part of the healing process. However, significant changes, such as pronounced bumps or depressions, should not be overlooked.

Here are some key points to consider when deciding whether to seek urgent care or wait for your scheduled follow-up appointment:
1. Symptoms: If you are experiencing any new or worsening symptoms, such as severe headaches, dizziness, vision changes, or neurological deficits (e.g., weakness, numbness), it is essential to seek immediate medical attention. These symptoms could indicate complications such as infection, hematoma, or increased intracranial pressure.

2. Pain Level: If the area around the surgical site is becoming increasingly painful or tender, this could be a sign of an underlying issue that needs to be addressed sooner rather than later.

3. Deformity Changes: If the deformity is rapidly changing or worsening, it may warrant an earlier evaluation. Changes in the skull shape can sometimes indicate issues with the healing process or complications that need to be managed.

4. Follow-Up Schedule: If your next follow-up appointment is only a couple of months away and you are not experiencing any concerning symptoms, it may be reasonable to wait. However, if you have any doubts or concerns about the deformity or your overall recovery, it is always better to err on the side of caution and consult your healthcare provider sooner.

5. Imaging: If you decide to wait for your scheduled appointment, it may be beneficial to discuss the possibility of obtaining imaging studies, such as a CT scan, to assess the situation more thoroughly during your visit.

In conclusion, while some degree of skull deformity can be expected after a craniectomy, any significant changes or associated symptoms should be taken seriously. If you are uncertain about the severity of the deformity or if you have any concerning symptoms, it is advisable to seek medical attention sooner rather than later. Your healthcare provider can perform a thorough evaluation and determine if any further intervention is necessary. Remember, your health and peace of mind are paramount, and it is always better to seek clarification and reassurance from your medical team.

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