Question on sore scalp

Hi, decompression on 3/20/23. Surgery went well, recovery has gone smoothly also. My only complaint is at the very top of my head about 2 inches to the upper right of my incision, my scalp is sore as heck. Almost bruised feeling

, but no visible sign of irritation. Is this just my scalp trying to heal?

Hey Monti,

And that’s because it kind of is bruised. A bruise is a collection of blood under the surface of the skin, the darker the initial bruise, the more blood is pooled and the darker, the sorer the bruise. When they’ve cut your scalp they’ve also cut through the scalp’s blood supply. They’ve pulled the scalp back together and sealed the wound, which is good for the wound healing, but it allows blood to collect under the surface and ‘feel’ like a bruise. Also when they cut the scalp they need to separate it from the skull, basically, to give them room. So the whole area will be fairly tender, again, like a bruise.

When they cut the scalp they also cut through the nerves. When these nerves are in the process of healing, they fire off signals to each other, trying to relocate themselves and that can generate some OMG type pain. I’ve required a few neurosurgeries and touching the scalp incisions post surgery with something like a hair comb I’ve described like ‘someone dragging a 240volt cable over my scalp’ Just unbelievably intense.

Within our scalp is a nerve known as the 5th cranial nerve called the Trigeminal nerve. Damage anywhere along this nerve can cause misfiring anywhere along the nerve tree and it’s associated branches. So although some of your pain may seem unrelated to the actual incision site, the nerve branches may well intersect in that region. There is a condition called Trigeminal Neuralgia and in very basic terms that nerve gets damaged and continually fires pain messages.

Now, I also need to say here, at 5 weeks post surgery, you are still healing. Most medicos will give a 6-8week timeline for wound healing. For some people that 6-8weeks can work OK, for others it can take longer and for some much longer. But at 5 weeks, that’s not looking too bad IMHO. I also have to say I’m not a Dr and if you have concerns regarding the healing please speak to your pcp.

But in short… “Is this just my scalp trying to heal?” I would suggest that’s exactly what it is.

Merl from the Modsupport Team