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View Full Version : Dent in skull after having an ICP bolt??



Los Pollos Hermanos
10-21-2015, 03:38 PM
A short but strange one, pretty please!

I have a character (Mr Fed from the last thread) who spent over a week in ICU after a nasty car crash. He had one of those intracranial pressure monitoring bolts inserted for a few days and I'm wondering if, a year later, he would be able to feel a (slight?) dent in his skull through his skin if he prods around.

During my googling I found reference to someone having a dent after numerous bolt insertions to monitor their hydrocephalus, but no other sources saying there would be a dent after just having one once.

Are there any doctors in the house, or maybe someone who's been unfortunate enough to have had a bolt?

Many thanks in anticipation,

LPH.

MDSchafer
10-21-2015, 04:09 PM
I'm a neurology nurse, and the short answer is no. ICP monitors use a 19 gauge or a 18 gauge needle, which is within the same size range we use for IVs if that gives you any sort of size reference. Sometimes they're double, or triple, ports and have two, or three, needles injected in the same port, but even then the hole in the skull is remarkably small. The bone remodels and fills in the bore hole inside three months.

Los Pollos Hermanos
10-21-2015, 06:35 PM
Marvellous! Many thanks for confirming what I assumed would be the case. I'm editing a scene where he's looking at the scars which serve as a visual reminder of his ordeal, and suddenly thought "Would he have a dent in his noggin?"

I did read somewhere that you can sometimes feel a slight ridge where there's been a linear skull fracture. Is this accurate information?

Cheers!

:D

MDSchafer
10-22-2015, 01:48 AM
I work in acute care, so I really don't see my patients for more than a few days to a week or so after their injuries and don't have any practical experience with long term healing. I know you're not supposed to feel an old fracture, but I'd be willing to believe some people could. It's not out of the realm of possible outcomes.

Los Pollos Hermanos
10-22-2015, 09:15 AM
It isn't essential that he has any head-based physical reminders of the crash. Personality-wise, he's still the same with regard to his devotion to his job and family, although he has a slightly shorter fuse than before. This is especially noticeable when it comes to dealing with baddies!

Cheers...

GeorgeK
10-22-2015, 09:24 PM
Like as was said above, the holes are small enough that they will fill in and remodel with time.

frimble3
10-23-2015, 10:20 AM
I work in acute care, so I really don't see my patients for more than a few days to a week or so after their injuries and don't have any practical experience with long term healing. I know you're not supposed to feel an old fracture, but I'd be willing to believe some people could. It's not out of the realm of possible outcomes.
I'd bet it's not unlikely that a patient could imagine that they can still feel the dent, especially if there's scarring in the area that would 'remind' passing fingers or comb that something happened right there.

GeorgeK
10-23-2015, 05:29 PM
I'd bet it's not unlikely that a patient could imagine that they can still feel the dent, especially if there's scarring in the area that would 'remind' passing fingers or comb that something happened right there.Easily

Los Pollos Hermanos
10-23-2015, 11:36 PM
I vaguely wondered about scar tissue. I've got a dent in my head (skin) from when I got chicken pox a couple of years ago (first time case). It's in a similar position to where you see those ICP bolts inserted in photos and even now regularly seems to scab over, which is weird. It got badly infected at the time - you could smell it! TMI??? I peeled the scabby thing off so I could clean it up. Bleugh! Anyway, it left the dent, which I sometime encounter when I run my fingers through my hair.

I got a week signed off from work, so it wasn't all bad. ;)