I was diagnosed with 2 aneurysms that are 3 mm each . I saw an neurosurgeon in mount sinai hospital who told me they are in safe place we just need to monitor them.and I took another opinion from NYU Langone who told me that I need to do an angiogram because one is in safe place and one no and he recomnded surgery . I’m lost please any advice .
How long ago were you diagnosed? How were they discovered? What was the amount of time that you were looked at between the 2 places? How do you feel? Also how do you feel about the drs that told you this, both of them?
I had an MRA on April 5 and I went to see the first neurosurgeon on this Monday and the 2 nd one on Tuesday so everything was this week .regarding doctors everyone was sure about what he was saying
2 differing neuros with 2 differing opinions… …sorry to say, but that’s not unusual. I’ve had 2 neuros both profess to me ‘I’m right and he’s wrong…’ ‘No, I’m right and HE’S wrong…’ and the back and forth of it all frustrated the daylights out of me. I’ve required a few neurosurgeries and with each I’ve had comments like ‘Well, I wouldn’t have done it THAT way, why did he do that??’ which only served to make me question the advice/treatments I’d already received. Many neuros will use the ‘Wait and Watch’ theory to monitor any changes over a period of time. If there is little change over the time period surgical intervention may not be required or could cause more issues in the long term and, let’s face it, if they can avoid neurosurgery, it’s better that they do.
I have to say it’s not that the advice you’ve been given is right/wrong but rather 2 differing approaches. Some medicos work on the theory that if the annie is less than ‘X’ mm in size, the probability of rupture is minimal and as a theory, this maybe correct BUT size is NOT the only contributing factor to be considered. Both the exact location and type of annie also needs to be examined. For example, if the annie is located where a vessel splits and forks off, the vessel wall could be thinner and therefore weaker than if the annie was in the middle of the vessel and not at a ‘fork’. As for the type of annie, some can be a thickening of the vessel on both sides (less likelihood of rupture), where as, some can be like a bubble out one side of the vessel, making the vessel wall thinner (higher likelihood of rupture).
An angiogram could be considered like threading a camera through the vessel to physically see what is occurring at the exact site, it’s another diagnostic tool and is often considered the ‘A grade’ diagnostic tool when it comes to annies. But, again, the 2 approaches, even with an angiogram being conducted, may still not be the same as every Dr will have their own approaches/treatment plan. It truly can be a case of which dr you are more comfortable with, which approach you are more comfortable with and which treatment plan you are willing to accept.
Hope it helps
Merl from the Modsupport Team
Thanks for answering @R1ck‘s question. I agree with Merl, doctors always have different opinions based on their experience usually. I recall several years ago there were two camps based on two different research conducted. One said anything below size “x” won’t rupture and the other study said different. Mine was in the other study. I have a 5mm multilobed aneurysm that ruptured. My Neurosurgeon stopped counting at 24 daughter sacs. Think blackberry and not blueberry. It was also at a bifurcation (where it splits).
Angiogram is the gold star for really seeing the aneurysms according to most everything I’ve read. I’ve had MRAs since I ruptured where the Radiologist didn’t get it quite right and others that were spot on. So for me, I’d do the angiogram despite the risks. I can no longer have angiograms due to my allergic reactions unless it’s to save my life according to my Neurosurgeon who I obviously trust since she’s been in my brain over a dozen times.
The other thing you might try is to have your images sent to yet another Neurosurgeon for a third opinion. Sometimes there’s a charge for them to read it, sometimes not. I would also suggest to stay within your State. I know many members travel outside theirs and some have had troubles getting any help within their state afterwards. Or you can ask the members for a neurosurgeon recommendation. One of our members travels from the South to NY because of the trust she has with hers.
Thank you for replying and the advice . I really appreciate it .
Yes you right . I believe I’ll go for angiogram and then decide after it . I’m dealing now with height anxiety if my Annie will rupture . I keep focusing on my headache and anything that is happening to me .
Don’t let your aneurysms get in the way of enjoying life. Allow a certain time to acknowledge them and then go enjoy yourself. There are of course the rules we are supposed to follow- reduce stress, eat healthy, don’t do drugs, don’t smoke, watch the amount of alcohol, exercise, etc.
Even with mine at 8mm, two different surgeons told me docs would be very split on whether to treat or watch and wait. Both told me I had to make the choice what to do since there are real risks either way. I waited for a year, and though it did not grow, the constant background worry led me to decide to treat. I also did a lot of reading that year on a couple facebook groups, one for people with un ruptured aneurysms, and one survivors of ruptures. That reading really helped me understand the risks of treating and the risks of waiting and which risks I was OK with and which I was not. Thank goodness that you know you have them so you can be proactive with either monitoring or treating. Hope you find some comfort it that double edged sword.