Removal of screws & plates

Hi,
I am new to the group. Five years ago I had a clipping for an unruptured aneurysm. All went fine. I have 4 titanium plates and about 40 screws.
The last couple of years I’ve had chronic headaches sometimes crippling. I’ve tried various medications. I’ve been through 3 or 4 occipital nerve blocks with some success and the last set of injections was a C2, C3 injection with success. However, my headaches always come back & they are pretty much daily varying in intensity.
I have one long divot going down the top of my skull that’s getting deeper & wider. It has also spread down my forehead to my eyebrow. I never had it go down like that. I also have several screws that seem to pushing out.
Has anyone ever had their dents or divots get bigger or spread? Why would this be happening after 5 years?
Has anyone had plates or screws removed? What is the procedure? I am nervous about going through another surgery but I don’t want to continue with this pain.

Welcome Sfw918! I tied a google search for post craniotomy and couldn’t find anything, perhaps I’m not asking the Internet the correct question…what has your surgeon said? I’ve only had coilings and I know hydration and protein are key to our brains recovering. I hope the members who have had craniotomies will be able to help you. In the meantime, have you contacted your surgeon?

Hey Shannon,
Firstly welcome to Ben’s Friends
I have had a craniotomy and the bone flap is held in place by screws and plates. On each side of each plate are some 10mm deep hollows. I don’t know that I would say they have become deeper, but certainly more pronounced over time. Although they are fairly prominent nobody really sees them as I wear a hat 90% of the time. For some people bone conditions such as osteoporosis can have an impact on healing or absorption of the bone flap.

The headaches are often beyond belief. Most people truly have no idea just how intense they can be, initially the dr’s kept telling me it was ‘healing pain’, but after the healing time had passed I was still in agony, daily. I too have tried all sorts of medications, but without any great joy. I’ve tried Botox injections but again without much benefit. I’ve had neuros tell me that the grey matter itself has no pain receptors, so it’s not actually the brain the causing pain. But the meninges or the layer over the brain does have pain receptors and during a craniotomy they have to go through this layer to get to the brain itself and this damage can cause ongoing issues for some craniotomy patients.

I still have all of the plates and screws in place, but I have another family member who has also had a craniotomy. The screws on one plate had worked themselves out and the screw heads were visually pressing on her scalp. Her surgeon decided to remove that particular plate but left the remaining screws and plates in place. In saying all of this though each individual surgeon will have their own opinion and approach.

Now, as a word of caution here, I have had a few neurosurgeries, each has been to ‘fix’ an issue BUT in trying to ‘fix’, the side effects of the ‘fix’ have been numerous. Individually those effects can be managed with medications and lifestyle adjustments, but when those effects are compounded the effect can be HUGE. In my humble opinion, surgery should only be done as a last resort.

Hope it helps
Merl from the Moderator Support Team

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I had the same as you, unruptured clipping. This March is 6 years. After about 1 1/2 years I began migraines which I am now diagnosed as chronic. I have tried a slew of medications and nothing works for me. My only saving grace is maxalt. It took me sometime to get to know when to take it to be effective but I finally have it down to where I can get relief. Don’t know if you ever tried it. As for my divit in my head and bumps/valleys… I would say they have probably stabilized at this point, I have nothing that is bothering me. I have a couple spots that stick out further but haven’t had an issue… hope the migraines get better for you

Hello, and welcome…I’m in the same boat, my head Always feels as if either I have been tackled onto concrete with my head hitting first or like someone slammed me in the head with a 4x4 – ALWAYS…My scars and screws seem to be doing like yours, never have had them removed, nor has anyone ever suggested so…It has now been almost 15 years for me, my prayers are with you…God Bless, Paul

I have been suffering with them since my craniotomy 13 years ago. I have been on all types of medications but no fix. I had a radiofrequency ablation of my supraorbital nerve and that helped a lot. Now I am going to see a neurosurgeon who burns the base of the trigeminal nerve inside of the neck. Not sure if that will cure me but hopefully it will at least help some.

Interesting as I am in severe pain from the screws. They have tried many injections with no success. I am having the surgery next week to have them removed. Not easy but only choice I have.

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I had C2 & C3 injections today which will hopefully provide some relief. I am having an MRI next week to look at the plates & screws

They are talking about the ablation of the occipital nerves as another step as well for me. They did a C2 & C3 nerve block today & I am getting an MRI next week to check on the plates & screws.

I had subarachnoid hemorrhage and 2 unruptured clippings done nearly 13 years ago. Prior to the surgery my migraines were unbearable and frequent. They warned me that I would still continue to have the headaches post op. However I have just regular very manageable headaches now and no problems with my screws or plates. I am so sorry that so many of you are having these problems. I will pray for all if you for your headaches to stop.

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I had a cranioplasty in 2014 to repair a sinking bone flap from a ruptured aneurysm that was clipped in 1995, so
almost 20 years later. Over time, the bone cement used to close the craniotomy was absorbed. They had to peel away the old bone pieces and cement used in the repair that had attached to my brain. The insurance wouldn’t pay for a titanium plate, so they used a new kind of bone cement to patch me up. I had no choice but to have the surgery, since the only thing between my brain and the world was skin and fragments of bone. It wasn’t cosmetic surgery, but my skull was so misshapen that it was visible to anyone. The cranioplasty was a difficult recovery. The nurse told me they had a hard time awakening me when I came out of anesthesia and they were all worried I might not wake up. I had been working, but ended up on disability after the cranioplasty because of the cognitive effects. The headaches are so much a part of my life, they are almost my normal. Sleep, quiet and dark rooms, protein and hydration, avoiding the cold, not lying on the craniotomy side… I am still here. Good luck on your decision.

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I have a shunt from problems after a ruptured aneurysm, they did coiing but swelling from MRSA occurred so shunt and piping inserted at my hairline. I can feel screws, shunt and dent/divot is getting larger.

I have constant headaches too. My surgeon said hardware is probably not necessary now, but don’t want to relive hospital or surgery. I had intensive care hysteria, my memory isn’t clear on all that happened but friends and my body recall.

I need knee and cervical work but want to avoid surgery or hospital. I use otc migraine excedrin and it works better than rx meds. Best wishes with your headaches, hope you can find relief. I’m in starting my 9th year.

Am so sorry about the headaches. Mine have lessened.Didn’t have clippings though… coiling-not good. I hate to say that docs might help you w the divot. If you are in the US, I would get a doc appt ASAP. Humans have a lot of nerve endings in their head/face, some of that pain seems to come from there a bit. A second opinion from someone other than the clipping doc. I had 2 herrington rods removed from my back… Doc said cuz I wasn’t compatible. They fused my spine. Take care

I’m a bit of the belief that headaches/migraines are not normal. I’ve had three migraines in my life. Two in my 20’s after leaving a country club and a third which turned out to be my aneurysm. There is a correlation between pesticide exposure and headaches. If you are having your lawn treated or your neighbors are or you live by golf course, park or farm, there is a possibility that pesticide exposure is adversely effecting you. I’m sensitive to toxic chemicals. I’m sure I’m not the only one.

P.S. Even Lysol disinfecting wipes, their main ingredient is actually a pesticide. They recommend washing with soap and water afterward.

What made your dr decide to that you could have the hardware removed?

He just said it was probably not needed anymore but removing it would create surgucal distress and he knew my reaction to that was not good.that surgeon is long gone, so who knows what would be advised now. Just keeping up with other medical problems is keeping me busy (and poor and tired) . I just think if it’s not causing trouble leave it alone. So much other things to address. Cosmetic and comfort issues at bittom of list.

Had the plates & screws removed on Wednesday

2 info’s of advice. Hope this might help someone.
I had my craniotomy back in 2011. Titanium plates & screws on my left side near my eyebrow. For the last 9 years I have had to sleep on my right side due to the fact that the screws near the brow stick out and the pressure of them sleeping on left side is intense. I was told that taking out the plate & screws would be considered a cosmetic procedure which I don’t get if the plate/screws is causing pain. I am 69 and don’t care about the appearance because I can cover the screws on the brow with wearing bangs. I also have an indent that goes down to the top of my ear lobe.
As for the headaches, I had 24/7 migraines. NO headache prior to the surgery let alone migraines. Neuros tried some meds, but no luck. It was here in this group that someone told me to try VERAPAMIL. I started immediately and it does take approx 30 days to kick in. My dosage was about 90mg per evening, pill form and now down to 40 per evening. Verapamil did work for me and I am so very grateful to the person here that offered that advice. I still have my plate and screws and they still are painful to sleep on. Also, sometimes when I brush my hair, I accidently forget and hit the screw with the hairbrush or press to hard with a washcloth, etc. I try to be more careful and try to protect that area of my head should I fall, which I do constantly. Many broken ribs, arm, foot etc. Doc clipped the aneurysm, but I developed other continuous long term conditions post-op for which the Doc’s claim should not be from the surgery. Well they are wrong, RLS, migraines, hairloss (which has stopped now), unable to open my mouth fully due to cutting of the muscle by the jaw, falling/tripping, etc. Also had about a 3 month loss of using my abitlity to walk due to something during the surgery. Neuro could not explain why. Almost 2 years later the Neuro told me I did have some mild brain damage but did not tell me what it was. The indent does look more prominent if I try to pull my hair back with clips. 7 years post op I now found out I have a brain tumor next to the crainiotomy called a menigioma. I don’t want to know anymore so I just dont mention anything anymore. Have not had any new MRI/MRA’s etc since the tumor (found by mistake). The tumor can grow and could be cancerous, but only way to tell is with another craniotomy which I do not want. For myself & my age, I just leave it up to God. IMO, fix one thing, 7.5 cerebral aneurysm and end up with 5 more lifelong problems.
No followup studies have been done to my knowledge regarding crainotomy.
Hope anyone with longterm headaches/migraines gives the VERAPAMIL a try for at least the 30 day to kick in to work.
p.s. I also have had INTERNAL, in the skull itching, every day since OP which is frustrating. I assume from under the skull or hair when removed. Again, no answer as to why or how to stop it.

I did a search on this myself, and found that there is an article, I believe from Japan, where they removed plates/screws because of headaches. Indeed, the removal caused relief.

You may have to have access to a library and search medical journals, that is what I did. This is a rare procedure and was experimental to see if that relieved the headaches.

I will try to find the article and post.

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