DX with 2 Acom Aneurysms Incindentally....Confused

Hi ,
In June I had an MRI & MRA due to hearing my heartbeat in my ear. It turned out to be nothing and cleared up , it was chalked up to my bad sinuses and my ear being clogged.
However the scan showed a possible aneurysm so I was referred to a vascular neurologist. He reviewed the scan and told me it was a infundibulum. As he looked at the rest of the scan he pointed out two little knots and wanted to play it safe so he sent me for a CTA. Well I get the call that they are indeed two very small aneurysms to small to even measure. I myself looked at the radiologist report and he didn’t even pick up on this, in fact two different radiologist didn’t see them…MRA &CTA read by different doctors.
My neurologist nurse was the one who called me with the results and told me to come back in 6 months for another CTA scan to see if they’ve changed.
Well now I have many questions and was told I should just make an appointment to come talk to him and to put my mind at ease.
I decided to get a second opinion from DR. Potts at Northwestern and that is this coming Tuesday.

I’m confused as to how two different radiologist missed this, I did ask doctors nurse and she said that my doctor is an eagle eye and picks up the smallest of stuff.

I worried as I read that Acom are harder to treat and have a history of rupture at a smaller size.

Midwestgal, Thanks for posting! It’s my experience that every Radiologist reads things differently. It’s the “open for interpretation” part of medical science. I’ve had confusing reads several times. One scared us so bad we asked about it without the preliminary greetings. She took a look at what the Radiologist and written, called immediately and it was corrected before she came back, sat down and opened up the results again.

I go by what my Dr sees when she’s doing the angiogram. I always get MRAs now, no CTs unless I end up in ER. I think it’s important to know that no two peoples veins and arteries are the same. If they are aneurysms the watch and wait are usually what is done for the small ones.

I am curious, if they’re two small to measure how are they seen?

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Good question. The nurse is the one who said that and I’m thinking it was because neither radiologist were even seen them …I’m still not sure how two separate ones didn’t see them at all. On the MRA they looked like very tiny knots and the doctor said he wasn’t impressed by them but we better check them out to be sure.
I’ll know more next week. I just know that Acom annies rupture at much smaller size than others

This caused me to remember a case study that was done in NYC back in the 60’s or 70’s. I learned in school in the late 70’s early 80’s. They asked people on a busy intersection what they had seen, no two stories matched. I think of Radiologists in the same manner. It’s all based on the time taken, what they think they are looking for based on what the prescribing doctor has provided and what they actually see. It may have been such that they didn’t think it was anything but the irregularities often found in the brain.

There was also a really good paper explaining arteries of the brain, can’t seem to find it now. But my favorite thing about the writer was his saying of “except when it’s not”. His point was to ensure the doctor students understood that things aren’t always where they’re supposed to be or look like the drawings. I believe the paper to be written from some university in NY. Next time I find it, I will have to bookmark it.

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