2mm aneurysm in left ICA (cavernous segment)

I suffered a central retinal artery occlusion (CRAO) in my left eye in October 2011 due to an underlying condition that has yet to be completely identified and am now legally blind in this eye. Since then I've undergone lots of testing including echocardiogram which showed I had mild calcification of my mitral valve, ultrasound of my carotid arteries which showed they were patent, MRA which showed that might have vasculitis and also showed a long astheroclerotic segment in the left ICA. I was referred to an interventional neuroradiologist who performed a catheter cerebral angiogram in December. The results from that procedure showed that I have a 2mm aneurysm in left ICA in the cavernous segment and that the suspected segment was plaque was indeed there but smaller than originally thought. No vasculitis was identified. I was referred to a neurosurgeon and he consulted with my interventional neuroradiologist and both agreed that I needed to have a follow-up cerebral CTA in 6 months. Ever since the CRAO, and even shortly before, I have been experiencing headaches on the left side of my head, dizziness, lightheadedness, and balance issues. Neurologist and neurosurgeon believe that this is due to my left ear. But I was born with the profound hearing loss in ear and in my 50 years have only once experienced vertigo over 30 years ago. This is not vertigo. This more like motion sickness that will NOT go away and I feel like I'm floating sometimes. I have fallen three times since CRAO and all three times the falls were because I lost my balance. The last two falls were especially scary. My neurologist and the neurosurgeon have basically belittled my condition. I'm having the most horrible time trying to get my CTA scheduled and images reviewed by the original doctor who did my cerebral angiogram. Could my symptoms be caused by the aneurysm and stenosis in my ICA? Since the CRAO, I am taking atenolol, lovastatin, aspirin, benadryll, and zyrtec, daily. I've also been diagnosed with GERD (or acid reflux or esophagitis) advanced osteoarthitis in my cervical spine and have added gabapatin (for tingling/numbness) caused by cervical arthitis and vitamin D supplements for vitamin deficiency since I've malabsoprtion issue.

I finally got scheduled for my CTA today so I'm looking forward to seeing whether my aneurysm has changed or the astherosclerosis has changed. My PCP ordered blood work yesterday and some of it has come back. My cholesterol has gone down and reached the level that they wanted for my HDL which is good news. However my BP has been spiking for for the last few months and my PCP and ENT are finally convinced that my dizziness, lightheaded-ness and balance issues are not related to my deaf ear that I've had my whole life. My PCP referred me to a new neurologist and I have an appt with him next week. Next is to schedule an appt with the endocrinologist to see if my hormones or kidneys could be causing my BP to spike like it has.

Has anyone experienced the symptoms I've had that could be attributed to my 2mm unruptured aneurysm?

Hi Dee,

I'm so sorry for all the troubles that you are having. I am, however, glad to hear that you are making some progress through your PcP and that you received good results on your HDL levels.

I don't have any experience with CRAO. However, I do have lots of other issues and experience with doctors. :-( You see, I've had at least one unruptured aneursym all my adult life. I will share a few of my experiences with you in the hope that something I write may be helpful to you. I don't believe that any of these issues are directly related to the three unruptured aneurysms that I have, though.

About 5 years ago, I had an issue with dizziness and the "floating sensation" that occurred after I added vitamin D to my diet (after reading about the need for adults to get more especially if they don't spend much time outside). It turned out that my blood vitamin D level was already in the middle of the normal range so eliminating the supplement plus wearing a cervical collar for 30 days (my PCP's idea) to stabilize my neck eliminated my problem with dizziness. Considering that you have c-spine issues, too, this could be relevant.

Please check the side effects of the drugs you wrote about. It seems that almost everything you take these days can contribute to lightheadedness or dizziness. Gabapentin is a prime suspect. I also took gabapentin for a while for nerve pain but I could not tolerate it so, I gave it up. For me, the nerve pain is easier to live with than the "mental impact" of gabapentin. :-) BP and pain levels are directly related so, if your BP is spiking when you're hurting the most, your doctors shouldn't be surprised although it may not account for the magnitude of your BP spikes. There have also been several articles in the news recently about BP increasing when you take NSAIDs, such as Ibuprofen,and acetaminophen. Aspirin was not suspected, though. You may want to Google this.

My limited experience with GERD could be traced directly to the addition of dark chocolate to my diet. I eliminated the dark chocolate and the GERD went away. If you haven't had it for very long, please think about recent changes in your diet or keep a food to diary to see if you can find the specific foods that are triggering your GERD and eliminate them.

Good luck to you Dee in getting answers to your questions and finding some relief for your problems. May God look upon you with favor.

Carole

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Carol,

Thank you for sharing your experiences. My physical medicine doctor prescribed the vitamin D after blood work revealed that I was extremely (in the dangerous zone) vitamin D deficient (probably due to a combination of east coast paleness from lack of sun as as well as intestinal malabsorption). However my floating sensation, dizziness, balance issues, headaches all started way before I started taking the vitamin D. My vitamin D is climbing back up but still not optimal so my doctor has requested that I keep taking it for the foreseeable future.

Luckily I was able to get my CTA yesterday but when they gave me a copy on disk to take to the interventional neuroradiologist who originally did my cerebral angiogram, I looked at the images (like I always do when ever my doctors give me a copy on disk) and discovered that the wrong type of CTA of my brain/head was done as there was no digital subtraction to make it easy to identify aneurysms and intercranial atherosclerosis. Ugh!!! I'm very frustrated with my insurance (Kaiser) and primary care doctor. My PCD seems to care about me but she's got too many patients and details like this escape her frequently. The wonderful/brilliant interventional neuroradiologist is not a Kaiser doctor nor does he do CTAs and that's why I'm having so much trouble getting the instructions he provided to me to have a follow-up CTA implemented with Kaiser because they don't share/use the same communication systems or records. Add the fact that the hospital, that the interventional neuoradiologist works at, seems to have lost my records so my doctor at that hospital can't even refer back to my chart because the images he took are gone as well as any record that I was patient at that hospital. Luckily I have copies of everything the hospital did and will probably end up having to go there and let them make copies so that they can recreate the file.

Any way wish me luck in getting this straightened out. I'm very worried that my aneurysm even though it's small has grown particularly since my blood pressure is not stable for unknown reasons and that might explain why I'm feeling the dizziness, lightheadness, floating, headaches, and balance issues. I'm trying to get my doctors to intervene before any rupture/stroke occurs and intervention will reduce my risk of these things happening to me and I'll have a better chance a higher life expectancy. CRAOs have a high morbidity rate of less than 5 years because the cause of CRAO is difficult to diagnose and that is exactly what I'm discovering (no definitive cause of my CRAO has been found, just likely suspects).

Sincerely,

Dee

Hi Dee,

I pray that you will be able to get this all sorted out quickly. It is enough to have a serious illness to deal with but having to contend with all the administrative problems is just too much.

I encourage you to have your c-spine looked at as it very well may be contributing to your issues.

May God be with you through all of this.

Carole