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Meningioma - Problems After Surgery
Hi-
I had a meningioma removed in Jan. of 2006. I had a craniectomy and cranioplasty with a scar that goes from one ear over the top of my head to the other ear. The dura was cut and I have a titanium mesh plate and I carry a anyreusm clip card. Since the removal I have had 4 Grand-Mal seizures . I am on 400 mg of Lamictal 2x daily and .05 of lorazepam 3x daily, I also take synthroid and lipator. I have been seizure free for 6 months now -- BUT, I now have swelling in the surgery area and now I have a cyst looking lump the size of a walnut on top of my scar. It is red and sore to the touch. I had a MRI done prior to the "cyst" and the MRI looked good with no reoccurence of the meningioma. I went to see my neurosurgeon's PA about the swelling (the cyst wasn't as prominate then) and he thought I might have developed a hole in the mesh plate and CSF was leaking. Now the "cyst-thing" is hard and sore and I will see him in a week. He said to go to the emergency room if I have a fever. The PA wasn't sure what it was ... he even mentioned that maybe some of the cement may have made its way to the top of my scalp? Have you heard of such a "cyst" - what is going on? I have tremendous anxiety and serotoin up-take inhibitors only caused my teeth to chatter and made me have resting tumors . Could this swelling and cyst have anything to do with all the stress and anxiety I feel? Any suggestions ? Help?
Thanks - MJ
Answer:
Meningioma - Problems After Surgery
Hi MJ, thanks for your question. Without examining you I cannot say what the lump is, but I'm glad you saw your neurosurgeon's PA and you're scheduled for a follow up. Various problems can occur with meshes and other artificial material, the most feared being infection, in which case a fistula (hole) will develop in the skin, leaking pus. Fever does not necessarily accompany such an infection. In the case of infection, operative treatment may be needed. Of course, you this does not mean that you necessarily have an infection - there are many other possible causes for a lump to develop in the area. Unfortunately it's impossible to make any guesses over the Internet. Perhaps they will schedule a CT/MRI with your next visit if the situation persists - that would show a CSF collection, tumor recurrence and other possible problems.
Keep us posted on this one-
Answer:
Meningioma - Problems After Surgery
Dr. Joshua,
Here is an update -- the lump on my head developed a large pus head and it burst. I went to the emergency room and they said I had a incisional abscess. They cultured the pus and took lots of blood -- everything came back "normal". They did put me on 2 types of antibiotics. The abcess drained for 4 days and finally developed a dark scab. NEW PROBLEM - now I have new CSF swelling and a new lump is developing fast and it feels and looks like another abscess is erupting. The lump is only 1/2 inch from the other lump and just above my incision on the top of my head. I am worried. I see my neurosurgeons PA tomorrow to try and figure this lump out! The PA did mention that if "bugs" got into the cement from my crainiectomy that it would be a bad medical situation. I have lots of questions I will be asking tomorrow -- but I value your opinion and would like to get your take on my new abscess.
Thanks - MJ
Answer:
Meningioma - Problems After Surgery
Dr. Joshua,
I just posted a reply but wanted you to also know, I am not running a fever. Is the "lump" in my brain? Or, because it developes a pus head and drains is it sitting on top of the crainectomy? Is the infection running underneath my scalp and will continue to erupt in other areas of my head or in my brain? I will ask the PA all these questions, but what is your opinion.
Thanks again,
MJ
Answer:
Meningioma - Problems After Surgery
Hi MJ- Unfortunately antibiotics often do not cure these infections. Almost always, surgical revision is needed. Usually the foreign object such as the mesh, has to be removed. The infection will then heal and a new cranioplasty can be done later.
The good news is that these infections very rarely affect the brain. The infection is almost always confined to the superficial layers, just under the skin and around the cranioplasty area.
Good luck, and keep us posted