Severe TBI - Cranioplasty
 

Hi all, I'm new here but I was reading through some of the old posts and found them helpful so I thought I might post my own story and ask an opinion on something I've been wondering.

I'm a 24 year old guy with a job working in higher education administration (I love it!). About two months ago (mid-March) I was hit by a car on the way to work and suffered a traumatic brain injury that resulted in two hematomas, subarachnoid hemorrhage, and a few other related issues. My GCS was estimated by the EMT at 3, but noted they didn't think they could perform the test accurately in my state. To treat, the doctor at the ER performed a decompressive craniectomy to remove a bone flap, withdraw the hematomas, and allow intracranial pressure to reduce.

I spent about a week in the neuro-ICU and another two weeks in a rehabilitation hospital before being discharged. I've been living with my family since getting out and no longer need a home aide. I have outpatient rehab two times a week, but every doctor's appointment has gone very well - there's no more blood in the brain, my temporal bone fracture has healed well so far, and my facial palsy has started to resolve itself. I'm also fully cognitively competent - it's extremely hard to remember anything from the accident or ICU, but the rest of my memory is almost entirely back and I can read and work from home now.

The last thing that needs to happen is a cranioplasty to replace the bone flap removed in the ER. Has anyone had anything like this before? I know it will make me feel better to not have a dent in the side of my head and have to wear a protective helmet, but I wanted some input on how that surgery went and if it made anything else better.

Thanks!

blessyouboys,

Welcome to NeuroTalk. Sorry to hear about your injury but I am glad to hear you are doing so well. I don't remember anybody on NT over the past 5 years who has had a cranioplasty. There may be a lurker. lightrail had a severe injury and may have some comments for you but he only checks in occasionally.

Just curious, Do you have the flap staying alive in your belly ? I understand that is a common protocol.

Compared to what you have already successfully endured, replacing the flap sounds like a much easier procedure and recovery.

My best to you.

Hi Mark in Idaho,

Thanks for the quick post! It is nice to know that I'm doing well and that any restorative surgery is bound to be better that healing from a brain bleed. Thanks for the input.

Thankfully the bone flap is in a freezer at the hospital, I remember hearing about that other way of doing things when I woke up and thinking it was like something from the X-Files!

Just curious, is it most people's experience that once cognitive and emotional competencies return after an injury like this, they tend to stay that way? Or are there sometimes situations in which people can lose that sort of thing again without reinjuring themselves?

Hi and welcome to NT.

My story is eerily similar to yours. I also had temporal skull fracture, an epidural hematoma and subarachnoid hemorrhage. My surgery was a craniotomy, the difference being the surgeon reattached the bone fragment after evacuating the hematoma, so I can't comment directly on your question on reattaching the skull flap (although there is still a small dent in my skull where the flap was removed).

I also work in higher education administration and I returned to work part time from home about four months after the accident, and full time two months after that. I still have no memory of the accident nor of the time spent in ICU. I was in ICU for four weeks followed by four weeks in neuro-rehab, then outpatient OT, PT.

The fact that you have regained cognitive functioning is profoundly encouraging. Reattaching the bone should be a relatively routine procedure (if any skull surgery can be considered routine). Your outpatient rehab sounds like it's going well.

Thanks for posting and keep us updated on your progress. Best to you on this recovery journey.

Just checking in to give an update. I had another appointment with my neurosurgeon today and he went ahead and scheduled my cranioplasty for next Thursday. Just over a week to go!

I've never had a surgery that I actually remember (my craniectomy was immediately after the accident), but other than not being sure how anesthesia/anything else relating to a surgery work, I'm feeling pretty good about it. I only had to have one CT scan before he said everything looked healed and was ready to schedule me, and I'll be glad to have my whole skill back!

Anyone with anything on what to expect from a surgery (vague, I know), feel free to chime in!

Wow, you expect to have your whole skill back ? Most of us hope to just get most of our skills back. LOL

That typo is called a brain fart. Welcome to the brain farting club.

Considering this is not an elective surgery, I suggest you not worry about the anesthesia. You have already done so well. Count your blessing and hope for the best.

I just noticed that i is right next to u. Maybe just a slip of the finger and not a brain fart. For me, they are rarely slips of the fingers and usually brain farts.

I type 'then' when I want to type 'those' Any word with the same starting letters is fair game with my brain.

What I expect will happen is your doctor will greet you prior to the surgery, a friendly nurse will take you to the OR, an anesthesiologist will .......

zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzz
zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz zzzzzzzzzzzzzzzzz

You wake up thinking um, what just happened and where am I?

I had 4 surgeries after my TBI (craniotomy, ORIF pelvis fracture repair, pulmonary embolism, IVC filter replacement). No memory whatsoever of any of them.

Based on your recovery progress thus far I'm sure you will do great.

Best to you.

Thanks to everyone for the tips! Just in case anyone was curious, just wanted to let everyone know I was discharged post-cranioplasty today. Spent two nights and they were actually just fine. Was told by the doctor that the cerebral contour is back to normal and that there's no mass effect, midline shift, or bleeding anymore. Great news!

As you said, lightrail, didn't remember anything. Once I woke up one of the residents told me "you did a great job buddy" and that's the first thing I remember. Told him I didn't help at all, but it was good not to remember anything else!

Really enjoy reading these forums, feel like I'm learning a lot!

Great news. Thanks for the update.

take care of yourself.