Thanks for writing to me. I had my Aneurysm clipped in August of 2011. It has has been quite an ordeal, anyway I am still here!! However, the screws in my plate are being rejected and are lifting....I am told this happens to one and 500 people who have clipping. I am planning on having them removed. As you can imagine another surgery is frightening. I do not have any friends on the blog so I was not sure how to go about finding information on removing the screws. Do you know of anyone who has had this done, and would be willing to give me some guidance? The screws cause headaches and are very uncomfortable...there are times when I wonder if they are causing other area's of my brain damage. It is rather frightening to live with this uncertainty. Can anyone out there help me educate myself on this procedure. Thank you to anyone who can help.
Who is your surgeon? What have they told you? Pat is right about the "ask-the-doc" it may take a couple of days to get an answer. Down on the right hand of your screen is the main room. You can talk to people and find out if any of them know about this.
Yes, the idea of another surgery has got to be very frightening--I've never known anyone to have the screws removed or that it was something that could even be considered...How long were you in your recovery until it was ascertained that the screws had begun to back out? My God, its bad enough to have to undergo a craniotomy/clpping to begin with, but now to have to go back in -- ugh, How is the procedure to remove the screws done...another craniotomy I gather? And how will you be 'put back together again' afterwards...I guess they'll remove the screws and since you've 'healed' from the aneurysm clipping portion of surgery ..then the surgeon will simply find/remove the screws, re- place the boneflap then suture you back up..(?)
I'm sorry, I've googled several different phrases relating to removal of the aneurysm screws yet have yet to come up with a result...Undoubtably something is or isn't in my 'phrase' that would give me a good answer!
You had said the Surgeon said that 1 out of 500 people might have this type of thing happen? Is it considered to be an allergic reaction to titanium or perhaps due to something else unrelated to the metal itself..like maybe the screw placement itself..? (Wondering aloud, don't mind me !)
Well Laura, you've gotten into a great website with a lot of caring, thoughtful folks who ask and answer questions, vent, laugh and cry--Welcome ! and hope to hear from others who've been in your position or know something more, Peace to you in your journey, Janet
I don't think there is a text book procedure describing how to do it, but it is dependent on the surgeon and his team's skill. Once the screws are removed, the plate could removed as well or maybe the surgeon might apply a epoxy like glue to hold it in place. We have investigated this procedure for my wife as she has stainless steel sutures securing her bone flap. The surgeons we consulted had differing opinions except they both concurred it would be too risky a procedure for her because the operating surgeon applied epoxy over the sutures as noted in his report of operation. We discussed possible alternatives such as removing a small section of each suture but that only appeared to compound the risk of infection. The solution now is to do nothing - the risks of severe infection are too great a tradeoff for eliminating the headaches. The screws you have now will not cause any brain damage as they are not anywhere near brain tissue. Please make sure you are fully informed and you are comfortable with the risks before you go ahead with any surgery.
Ed...I am so glad you have so much to offer...I meant to note you In my initial answer to Laura...and, so side-tracked today...a long term friend lost her son today to cancer...I was distracted...
You have done so much research and offer so much...a blessing to us...
Janet...thank you for your thoughtfulness...We have been friends since third grade...I did spend a little time w/her dad tonight...The son's is another unique story I will share w/you some time...w/his strong, thoughtful, active doctor, Tim managed six years...tho he did leave his wife and two daughters, parents, brother, more family and numerous friends...I hope they will write their story some day...
I am new on the site, did not know there was a doc... My Surgeon suggested that we take them out. However, he is not the doc that does the removal. He referred me to a reconstructive surgeon at Mass General who has been a bit vague. It is not brain surgery again, it is topical... the main risk is infection. I have not had any real definitive response as to how the outcome has been from the surgeon which is why I went to this forum. Ed mentioned infection as well and some glue which I did not know about ... I need more answers. Thank you for responding I will keep searching have a wonderful day!
Thank you for responding to me.....yes, my surgeon said about 1 and 500, he said there did not seem to be a rhyme or reason and said it appeared that "it was thinner people" Lucky me huh. Anyway - it could be worse... my god I just found out a friend in Cal who was 40 passed from an aneurysm....so, so sad. I am glad I am on the site.... I will be searching the main room for answers as someone suggested. Still learning how to navigate this site. Have a glorious day!!
It appears you have some knowledge. I do not believe they were going to remove the plate...only the srews which are pretruding. I did not know they use epoxy....god there is so much I need to learn. The procedure will be done by a reconstructive surgeon and not my neuro surgeon so I have not known to ask this question. Thank you for reminding me the screws are not near brain tissue as I do get nervous that by body chemistry or something is changing because of this. The headaches and odd aches leave me nervous. The only risk the surgeon did mention was possible infection. But made light of it as it can happen in any surgery. Ed, thank you for your feedback. I need to get more answers and you have helped me see that. God Bless you, your wife and family.
Thank you Pat. Cancer is another research area I'd love to tackle because it has also hit home with my family and friends. I'm sorry for your friend's loss. I'd love to have the time to construct a interactive flow chart mapping system to help folks process the different stages they or a family member might be in and helpful hints to direct them through the stages from aneurysm diagnosis through post surgery recovery. Hmm, got to think about that one!
You got me thinking, try asking your Doctor if it is possible to try the following surgical strategy. Rather then remove the screws, would it be possible to retighten them slightly and then apply what is called methylmethacrylate as an overlay over the screws. It would accomplish two things: 1) prevent the screw from loosning; and 2) provide a smooth overlay so overlying muscle and dermis layers would be less sensitive to the screw edge.
The downside is what I had described in my first post. Also I can't exhonerate the screws as a possible source for your headaches. Even though they are described as titanium screws, they may have enough carbon based alloy in them to interact with electromagnetic fields and stimulate scalp muscle contraction, hence pain. (Please be aware that physicians and surgeons are not trained to understand this phenomena in cranial implant patients.)
You certainly have done some research--that's great, this kind of info helps all of us understand some of the 'not usually spoken of' areas of a craniotomy procedure. Keep up the good work ! and thanks !
Hi Laura. I totally understand your dilemma. I have the same problem although my neurosurgeon told me back then it would be considered a cosmetic procedure and might not be covered. He told me this 2 months after my surgery and that area on the left side by my eyebrow/ear area was still swollen so the screws were not obvious like they are now. I am not concerned about the cosmetic look but am concerned about the discomfort the screws do cause when any pressure is put on this area. Just lying down on a pillow is a no no, rubbing the skin around the eye area while washing my face causes pain, scratching that area which still goes on post-op healing and finally stretching my hair outwards for a hair cut. I had a titanium clip, screws and plate, done on 10/2011. Upon opening the skull the surgeon found another very small aneurysm in that area so he repaired it with the 'glue/gauze' procedure that they use. After almost 2 years I do not feel its a cosmetic procedure. I would only be doing it because of the pain. Since my 2 month consult the swelling is gone which at that time was a cushion and I had no discomfort. There is only skin covering my screws. They do protrude and seem to put pressure on the bony eyebrow area they are in. In December of 2011 when my surgeon told me he could take them out I walked away feeling that it was not a operation of concern I did and still believe that. It's still my choice though and like you not sure which way to go only because of the fact that it is still in the aneurysm area and still an aneurysm, but only now it is a clipped aneurysm. I will add that I am wondering if the skull/screw area is still healing and filling in with bone, etc. I have noticed a slight shifting in that area which I assume is part of the healing being I still have itching going on. If I were to fix it I would try to have it approved by the insurance company because for myself it's not cosmetic but the pain the screws are causing. I hope I am making sense. Since the operation I have had trouble at times organizing my thoughts correctly in writings. Please let me know what you decide. I wish you the best. Jeanne
I know this post is old, but I’m new to the group and am wondering if anyone has any insight. When I was 23 I had a ruptured aneurysm and underwent emergency sugery for the clipping. I went into vasospasm and was in ICU for 2 weeks. Recovery was 100% and I went on with life. 2 years later, I had a follow-up CT and 2 unruptured aneurysms were found–back in for clipping surgery. This time there was a complication and the optical nerve (that controls the eyelid) was hit so when I woke up, my right eye was sealed shut. My surgeon was amazing–same surgeon for both surgeries–and he promised the eye would open in 12 weeks. 12 weeks to the day, it opened! It took a while to adjust to seeing out of two eyes again but once I readjusted, all was fine. Fast forward 20 years (I’m now 43) and just had routine follow-up CT and now I have a screw loose!!! My surgeon says it should come out and they will just go in through the half moon scar on my scalp and he makes it sound like nothing. But really, a screw loose? Wondering if anyone has had this done?
I hope this reply isn’t too late.
I’ve had that done. If you mean a screw on one of the skull flap plates. I had a couple come loose and they were causing me a lot of pain because of scar tissue.
They do go through the same incision. However, they will have to go through all of the fascia, layers and everything else again as well.
I’m glad I had it done and it wasn’t as easy as my surgeon made it seem. My surgery was on the right side of the ACoA and they had to cut my jaw muscles to get to my skull. That was done again to remove the screws.
I’m still glad I had it done…and it’s a cake walk compared to the brain surgery! Good luck and I hope you get this resolved without too much of a problem.
I don’t blame you one bit. Just know you have been in my thoughts since I read your post.
It’s a hard decision to make…you have knowledge of what it was like the 1st time. And…there have been tons of medical advancements that might make it easier this time round??
Good luck and I will continue to keep you in my thoughts…
