Concussion years after Aneurysm Clipping: CT shows Laceration along Titanium Plate

I am 11 years post-op craniotomy for clipped brain aneurysm. Last week I was hit on the head with 50+ pounds of closet panels. Went for CT Brain (not Angio) the next day. One observation from the CT report is concerning:

“There is a question of a small scalp laceration along the anterior margin of the metal (brain aneurysm) plate. There are multiple tiny foci of hypodensity subadjacent to the plate of uncertain clinical significance. These may represent tiny gas bubbles or foci of fat.
No definite intracranial extension is seen. Comparison with prior studies would be helpful if clinically indicated.”

I am waiting for CT Brain Angio from 11/2020 to be comparatively read by my neurologist. My head still hurts, dizzy, nausea. My brain aches, and yes, I also have constant headaches.

I haven’t researched this info yet myself because my head cannot currently tolerate reading on a computer/iPad/iPhone screen without worsening these new head/brain symptoms. Loud voices/noises and bright light are problematic, too.

I have been unable to research scalp laceration metal plate or intracranial extension. I’m afraid I may be at risk of a brain bleed. If anyone has had concussion or blow to head following clipping, and has any info or insights to share, please do. Also, any thoughts on other diagnostic procedures I might consider would be appreciated. Prayers requested as well +


Yikes! That’s a nasty blow. You may want to reach out to the doctor who did your craniotomy. You can probably just send the images and findings to them. Of the two neurologists I have been with for any length of time, neither were trained to read images, is what they told me. That being said, they sure do like to get them. They rely on the findings of the radiologist. What my current neurologist did was send the images from the hospital I usually have them done at to the radiologist at the hospital where his findings were that he needed a comparative image. What I did was have the images at the hospital where my neurologist works out of to my Neurosurgeon. She quickly had another MRA done and put in my stent without the usual angiogram, she didn’t need it.

I’ve had a good number of concussions and they can make your brain wobbly for awhile. I haven’t had one since I ruptured, so can’t help you there.

I will definitely keep you in my thoughts and prayers. Hope other members can give you some insight!

All the best,

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Much appreciated, Moltroub!

Actually, I’m trying to avoid relying on the report of a radiologist, who is typically a generalist. I want the CTs compared by a specialist who looks at brain injuries/conditions all day, every day, not someone who sees every body part.

Today I learned my PCP’s family member just had a concussion from a waverunner accident and the PCP sent him to a guru neurologist locally. So I’ve requested my PCP’s office refer me to the same guru because I feel the situation is important enough to warrant a second medical opinion of a specialist or sub-specialist.

Also, I picked up a helpful tip from this forum: to request a plain x-ray of my head to show the exact location of the metal plate, and all the metal in my head, which is something I’ve often wanted to understand but I have never known I could ask for.

A friend also suggested I have a second CT of my brain/head performed after a certain interval of time has passed because as the trauma and swelling from the concussion dissipates, a subsequent CT scan often may show more clearly images and details that were not able to be seen on the first CT scan, which in my case was done the day after the blow to my head. If anyone here knows what that appropriate time interval is between the first CT scan and a subsequent CT scan for a concussion, please share.

Welcome purpleplume! May I ask why a second CT and not an MRA? I know CTs are used initially and the ER docs say they’re faster. A Rad Tech told me there is that much difference in time. For me personally, I prefer the least harmful way. Is it because of the plate?

I found this article Brain Scans for Head Injuries | Choosing Wisely

You can get a copy of your images for yourself and see them on your own computer for no cost. I was told by the Radiology Dept at my local hospital I wouldn’t be able to see them on an Apple computer but I went to the Apple Community and some kind soul provided me a link.

All the best!

Hi Moltroub!

I was told the same about not being able to view images on my computer as I am Mac-only. If you still have that info from the Apple community, it might be of help to others on BAFS as well.

Because my aneurysm was clipped in 2009, my titanium is only safe at a maximum of 1.5 Tesla. Today’s MRIs are preferred at 3.0 Tesla, which is not an option for me.

That said, I’m willing to have another CT Angio, although I had one less than 3 months ago (we do them every 2 yrs to monitor my clipped aneurysm plus a second untreated aneurysm which has been present since the first aneurysm, but was deemed unsuitable to coil or clip).

Many thanks for the link to the article on choosing your type of brain scan. I’ll definitrly read it to understand why a MRA might be preferable to view the status of the concussion versus a CT. You are a wealth of information, and so generous with your time and resources!

With Gratitude,

You’re extremely nice purple plum! I did do a new topic on the one that was suggested to me back in July 2020, Mac users can see images but for anyone following here it is OsiriX DICOM Viewer | Patients

I just changed it the word “see” to “view” in the title. I hope it helps others.

yes I am Apple/Mac user and have many times used the free Osirix to look at all of my images. They are fascinating!

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Hi Purpleplume,

Not a Dr. (biologist) The plates will be on the outside of your skull, outside the durum and protective lining. So while the concussion may have affected your brain by moving your brain side of the skull, the laceration would be a completely different finding and probably not affecting your brain. Hope this helps.

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What trekhard said about the location of the plate made sense to me. Please try to rest and take it easy. Let your neurologist know about ALL of your symptoms, there may be a recommended medication that will help you. Don’t try to tough this out on your own. Make sure you are eating good nourishing meals to help yourself heal.



This information helped me tremendously. Thank you for the gift of your time and knowledge in posting this information!


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