Your Questions
Your Questions
Q: Dr. Eppley, I have a bump on the top of my skull which appeasrs to have developed by injuring it years ago as a child. It would be difficult for me to send a picture of my bump since my hair covers it so perhaps I can describe it better. I am self conscious of the way it looks with shorter hair and effects the way I can keep my hair. It is like I said at the very top of my head and creates somewhat of a point. It is pretty swelled out and has more of an oval shape. It is similar to a ridge. I would love to somehow get rid of the bump so I can move on with my life. Personally it has had a profoundly negative consequence on my pyche throughout my youth. I am 24 now and am still reminded of its presence everyday. I have learned to deal with it mentally but the honest truth is that its a challenge to pretend it isn’t there. Thanks for listening and hope to gain more feedback from you.
A: Reduction of a prominent bump on the skull is a fairly straightforward procedure done through burring reduction using a small scalop incision. It is always helpful to see a plain skull x-ray from the front and side to see its thickness and how it compares to the surrounding normal skull. That tells me how much of it can be reduced and whether a completely normal skull contour can be obtained with this minor form of skull reshaping.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I was wondering if it were possible for a bump caused by hitting the very top of my head when younger could be removed. It creates a rounded point at the peak of my skull. I know it was caused by the impact and always thought it would just reduce on its own, but never did. I believe it hardened when the bone healed from the injury. It is something that I often think about and am trying to research to see if it could ever be realistically and safely renewed to its original shape.
A: You are correct in deducing that the bony bump that you have acquired is due to scalp trauma, particularly when it occurs at a young age. Any small amount of bleeding from perforating vessels from the bone causes an accumulation underneath the periosteum of the bone. The blood will cause the periosteum to turn it into bone, thus making the round bump that you have. That could be reduced by a simple skull reshaping procedure using a small incision to burr the bone down to the level of the surrounding bone.
Dr. Barry Eppley
Indianapolis, Indiana
Q: I’m a 6 year old male looking to remove a bump on my skull bone on the back of my head. I believe this skull bump resulted from a forceps delivery during my birth. I had an MRI of my head done and it came back normal. This is something that has plagued me psychologically all my life and I’m looking for any options to improve the appearance of the back of my head. I’ve provided photos of the back of my head. As you can see from the pictures, aside from the bump, there is also a ridge that leads to the more protrusive bump. I look forward to your assessment.
A: Thank you for making the effort to take the pictures. They are more than sufficient. What you have are two specific occipital bony uprisings, one ‘abnormal’ and the other a natural part of the occiptal skull bone. One is a small round bump at the top of the occiput which is a small osteoma or benign bony ‘tumor’ That can be burred down through a small vertically-oriented incision over the bump measuring about 3 cms. or just slightly bigger than an inch. Incisions in the hair-bearing scalp in men heal remarkably well and would eventually be such a fine line scar that it would be virtually undetectable. The horizontally-oriented bony ridge across the bottom of the occiptal skull bone is known as the nuchal ridge. It is where the top of the neck muscles attach to the lower edge of the occipital skull bone. It is raised and visible, as it is for some people, for unknown reasons. It may be raised because of the need for a strong bony attachment for the neck muscles. That can actually be reduced by burring down the ridge but the issue is incisional access. It requires a linear horizontal incision across the back of the head along the nuchal line, probably of a width of about 5 cms. Either skull reshaping procedure can be performed alone or in combination. Either way it is an outpatient procedure under general anesthesia that would have a minimal recovery. The incisions would be closed with tiny dissolveable sutures and one could shower and wash their hair after two days. There would be some temporary swelling which would go away in two or three weeks.
Dr. Barry Eppley
Indianapolis, Indiana