Brain aneurysm question

Hello all. I'm hoping you might be able to help me with my current situation. I have been suffering with migraines for many years. Last summer, I had been experiencing a lot of pressure in my head, so my neurologist sent me for an MRI/MRA. I was diagnosed with a 3.3 mm saccular aneurysm on the posterior communicating artery, which the docs said was an coincidental finding for they thought the aneurysm was too small to be causing my headaches and head pressure. Upon hearing this news, I began to suffer from extreme anxiety (and that is an understatement) I get bad headaches all the time, and every time I had a headache, i went into panic mode thinking the worst. I had altered my lifestyle tremendously. I became afraid to do anything...exercise, pick up things, even sneeze. My neurologist recommended that I see a neurosurgeon. Because of how worried I was, I went for 4 opinions...which might seem extreme. Two of the doctors sent me for a CTA, and to my surprise the CTA came back clear. I was extremely happy to hear that news, however totally baffled. I didn't understand how one test could show something and another be clear. I still did not have the peace of mind that I needed for I worried that the CTA didn't pick it up. It was then that I went for the 4th opinion. This 4th doctor took the CTA results and had them reconfigured so to view them from a 3D perspective and concluded that there was no aneurysm. This was 6 months ago. I recently called the 4th doctor that I saw to see if he would advise me to repeat images being that it had been 6 months, and he said it wasn't necessary to do so. He is a wonderful doctor and I trust him, of course, yet I just do not have peace of mind. I still am terrified that the aneurysm is there and would like to have another MRA. I definitely do not want to do another CTA as I had two done last summer and am now worried that I have exposed myself to too much radiation in a short period of time.

I apologize for the long winded post, but I really could use some help and advice as to what I should do next. Thank you in advance for any help you could provide!

Hi DianeLucy,

The Gold Standard in testing for an aneurysm is an Angiogram with contrast material.

This method was designed exclusively for one thing, and that is to view the blood vessels and arteries in their greatest detail, giving the Radiologist and surgeon an in depth view of your aneurysm, backwards, forwards and in between!

A CTA is great for a lot of things, but aneurysm detection is not necessarily one of them. I underwent a CTA -- and although I had a rather large posterior communicating aneurysm--the CTA did NOT see the annie....I was fortunate to get another test (MRA) which did see the aneurysm, which resulted in an emergency clipping within hours of the finding.

Considering that you've been thru 4 different opinions with a varying degree of what is and what isn't in your head, I think you need to get the correct test done in order to ascertain exactly whats going on (or not going on) in your particular case. Best of luck to you,

Peace, Janet

Hi Janet,

Thank you so much for your response and for sharing your experience. I am so glad to hear that everything turned out well for you. I am surprised because I was under the notion that the CTA was better for detecting aneurysms the MRA. The BAF website even says that the CTA creates better images than MRA. The MRA that I had was without contrast and the CTA was with contrast which is why I thought that would be the more reliable test. I really liked the 4th doc I saw and would like him to send me for another MRA, but he said it is not necessary and I guess i'm not sure where to go from here.

Thanks again!

Hi and I agree with Janet...the gold standard is the cerebral angiogram...but at this point I am not sure which Doctor would do this since they say you don't have a brain aneurysm. Like Janet my CTA didn't show either of my brain aneurysm's...however a MRA showed them and of course the true size and location was done by angiogram...

Now here's the thing...you have panic and anxiety which all of us understand...but if you have a brain aneurysm you need to be your own medical advocate and tell the Doctor...you want an angiogram because you have had so many different opinions...now if you trust was your Doctor has told you...then you need to seek medical attention for your panic/anxiety...it is not healthy to live this way...many of us have had it because of our brain aneurysm's...and we have had to learn how to live our lives...or we let the brain aneurysm's win...and life isn't worth that...keep us posted...and Good Luck on what help you can get from 4th Doctor...Thoughts out to you ~ Colleen