What is the next step after neurology?
I have a depression on the right side of my skull, which has been accompanied by a persistent feeling of pressure and tightness, even affecting my right eye.
Additionally, the right eyeball appears to be noticeably lower than the left, and the right side of my craniofacial structure (including the skull and face) seems to be lower than the left side.
I suspect this may be a result of an injury I sustained during childhood that caused the bone to become concave.
Therefore, I visited a nearby hospital's neurology department for an examination (which included an X-ray and some tests involving adhesive strips on my head).
After the examination, the doctor stated that my skull did not show any signs of depression and that I should try to distract myself, returning for a follow-up only if I experienced discomfort.
However, after returning home and feeling my head, I can still clearly detect a significant depression, approximately the size of an adult hand minus the fingers.
I am not seeking sympathy or exaggerating; the depression is very evident.
I attempted to distract myself, but found it ineffective, as the tightness continues to follow me, causing significant distress and severely impacting my daily life.
It is not merely a matter of distraction.
I believe this is not a psychological issue; rather, my strong mental resilience has allowed me to maintain emotional control.
My situation is somewhat similar to that of the individual mentioned in the news, though not as severe: http://news.cts.com.tw/cts/international/201403/201403141391829.html
Question 1: I am considering whether I should pursue 3D printing to reconstruct my skull to restore the concave bone.
Question 2: Will the depression worsen over time?
Question 3: What should be my next steps?
Xuanwo Mingren, 20~29 year old female. Ask Date: 2014/04/24
Dr. Gao Chunde reply Neurology
Craniofacial structural defects fall under the scope of plastic surgery.
However, regarding whether the 3D imaging reconstruction of the skull is covered by health insurance or is out-of-pocket, and whether surgical correction is necessary after the examination, there are specific eligibility criteria.
Neurologists typically have less experience with these regulations, so it is advisable to consult a plastic surgeon first before making a decision.
Reply Date: 2014/04/24
More Info
Your concerns regarding the skull deformity and associated symptoms are valid and warrant careful consideration. It is important to address both the physical and psychological aspects of your condition. Here’s a comprehensive approach to your questions and concerns.
Understanding Skull Deformities
Skull deformities can arise from various causes, including congenital factors, trauma, or conditions affecting bone growth. In your case, you mentioned a history of injury during childhood, which could potentially contribute to the observed asymmetry and indentation in your skull. The pressure and tightness you feel may be related to the altered structure of your skull, which can affect surrounding tissues, including nerves and blood vessels.
Question 1: 3D Printing for Skull Reconstruction
3D printing technology has advanced significantly and is being used in various medical fields, including craniofacial reconstruction. If your skull deformity is causing significant discomfort or functional impairment, consulting with a craniofacial surgeon or a neurosurgeon specializing in skull deformities may be beneficial. They can evaluate your specific case and determine if surgical intervention, such as reconstructive surgery using 3D-printed implants, is appropriate. This approach could potentially restore the contour of your skull and alleviate some of the pressure and discomfort you are experiencing.
Question 2: Progression of the Deformity
The progression of skull deformities can vary widely depending on the underlying cause. In some cases, the deformity may remain stable over time, while in others, it may worsen, particularly if there is ongoing pressure or if the underlying bone structure continues to change. Regular follow-ups with a specialist can help monitor any changes in your condition. If you notice an increase in symptoms or changes in the appearance of your skull, it is crucial to seek medical advice promptly.
Question 3: Next Steps
1. Seek a Second Opinion: If you feel that your concerns were not adequately addressed during your initial consultation, consider seeking a second opinion from a specialist in craniofacial surgery or neurosurgery. They can provide a more detailed assessment and discuss potential treatment options.
2. Imaging Studies: Advanced imaging techniques, such as CT scans or MRIs, may provide a clearer picture of the bone structure and any underlying issues that may not have been visible on X-rays. These studies can help in planning any necessary interventions.
3. Symptom Management: In the meantime, managing your symptoms is essential. Techniques such as physical therapy, relaxation exercises, or cognitive behavioral therapy may help alleviate some of the discomfort and anxiety associated with your condition.
4. Monitor Changes: Keep a detailed record of your symptoms, including any changes in the pressure sensation, pain levels, or visual disturbances. This information can be valuable for your healthcare provider in determining the best course of action.
5. Consider Psychological Support: Given the significant impact this condition has on your quality of life, speaking with a mental health professional may also be beneficial. They can help you develop coping strategies to manage the psychological aspects of living with a chronic condition.
Conclusion
Your situation is complex, and it is essential to approach it holistically. Engaging with specialists who understand the intricacies of skull deformities and their implications on overall health is crucial. By taking proactive steps, including seeking further evaluations and considering potential interventions, you can work towards improving your quality of life and addressing the discomfort you are experiencing. Remember, you are not alone in this journey, and there are professionals who can help guide you through the next steps.
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