How fast should the surgery be when you are diagnosed with unruptured aneurysm

Hi everyone.

I have almost the same complication as Wendi Ann Koening has ( an unruptured aneurysm of 7-10 mm in the left middle cerebral artery ). I have read all froum disscussions with wendi which almost concludes to undergo a sergery ASAP. I think I have to follow the same,but I don't know what would be the age factor in making that decision. I am 73 having hypertention controled by drug, should i consider sergery or not? Thank you in advance for all your helps.

Chavosh...a big decision to make. I had a 6mm aneurysm that ruptured; the larger sizes always amaze me.

I always get amazed at delays for larger size aneurysms. BAF has lots of stats on the % of aneurysm in various arteries' that do not include sizes of aneurysms of the different arteries.

What did your doctor recommend? I pray you have spouse/family to discuss your beliefs and commitments.

Best wishes and prayers for your right decision for you.

Pat

Ruptured aneurysms are best treated ASAP but treatment of an unruptured aneurysm usually involves indepth decision-making re: whether treatment is appropriate and if so, which treatment would be most effective.

This decision making is highly individualized and is based on such factors as the aneurysm anatomy and location, patient's age and medical condition. Physicians then usually determine the risk of treatment and

compare this with the risk of not treating. Sometimes there is more risk to treatment than not treating.

Several studies have shown that surgery in people over 60 - 70 years old runs a higher risk of complications and in particular, problems with thinking. Of course statistics do not apply to everyone. You need to have a discussion with a specialist to discuss the pros and cons of treatment for you.

Good morning. The surgery you talk of is a craniotomy or coiling? I can briefly tell you I had a 7.5 mm left cerebral aneurysm told to me on 8/15/11. I was told on a Monday, saw my neursurgeon on Thursday, and he explained all the procedures that were done for repairing a aneurysm. I am 61 and was a cigarette smoker ( ex now ) and I decided the craniotomy would be best for me. He operated on me on 10/10/11. I wanted it done asap from sheer anxiety on my part. So I guess waiting 2 months was not that long. Who knows how long we actually have them before they are found.

Again, 61 yrs old - 7.5mm ani - high BP - high cholesterol & excessive worrier.

One more thing once the surgeon went in he found a very small one in there that did not show on the MRI and fixed it with some sort of glue and gauze.

I hope you think it through and do what is best for you. Once I made my choice I stayed with it. I felt the ani was found for a reason. The internet has quite a bit of information on it also on the medical websites. This forum has been a tremendous help because you get to find out first hand what we all go through and the support of frienship is wonderful.

I hope my information has been some help. Prayers to you and your family. Jeanne

Hi Pat

Thank you so much for your comments. Here in Vancouver we do not have a quick access to the specialists. My 1st visit to a neurologist was on Dec 12/2011and he said as there is a teat along the dome of the aneurysm would probebly better if I consider a craniotomy and clipping versus coiling procedure. However the risks of the sergery he mentioned.ie, general anesthsia,infection,bleeding,medical complications,neurologic worsening ,cerebrospinal fluid lek,seizure,major stroke, interaoperative aneurysm hemorrhage,resodual aneurysm and potential need for revision surgery were so scary that I could not and still can not make a decision. I have asked my GP to arrange for a 2nd opinion and am still waiting for that. I am lucky to have my wife around me who she is very caring while very wory too.

I assume you are doing fine now after unfortunate rupture of your aneurysm. I'll be greatful to know more about that.

Thanks a million for your kind wisheds and prayers that I indeed need them.

Chavosh

Thank you Kathleen.

I am impatiently waiting to see a second neuralogist to discuss the subjects you mentioned. I am in the waiting list and perhaps see him inearly Feb.

Thank you Jeanne. Your information was indeed very helpful. As I worte to Pat, my neurosergon also recommended craniotomy but he simutaneously listed so many scary risks of the surgery that made me undecisive. This was before I learn about this wonderful web of BAF and its forum. Now I know much more about the anni and hope to learn more in coming days thru discussions with wonderful people like you. I hope by the time I see my 2nd opinion specialist ( hopefuly early Feb 2012) I will have my final decision.

Please tell me how do you feel now. How long it took you to resume your normal activities, did you have any issues after surgery?

Thank you again and wish you all the best.

Hi Chavosh,

This is such a big decision and I know that it is scary. I have unruptured aneurysms and I have deferred having any surgery or coiling mostly because of my personal history - they've been with me for such a long time.

I just visited with my neurosurgeon yesterday to get the results of my angiogram. I pointedly asked him again what was his criteria for determining the "urgency" of treatment. I'll share what I understood him to say with you and other members fo BAF.

History of a previous bleed, aneurysms bigger than 10mm, smoker or drug user (a big factor), life expectancy and overall health of the patient. He said that in his experience, the majority of the aneurysms that have ruptured are smaller than 10 mm.

Look to your parents and grandparents for life expectancy and the other health factors when trying to make a decision.

The risks of surgery are higher for folks over 60 (like us) but if you are in good health and expecting to live to 90+, surgery may be something you want to consider.

May God bless you with his healing powers.

Take care.

Carole

Hi Chavis,
I understand what you are going thru as I also have an unruptured anni and am very anxious about surgery. It was discovered in Aug 2010 at 3mm and has grown to a 5mm in dec 2011. I am 66 but have decided that I cannot live with the worry of it bleeding and am in the process of scheduling this week to hopefully have it clipped in February. I know it is not an easy decision and it’s scary as heck. Just go to the best surgeon you can find. I have done a great deal of research to find the best. Good luck to you.

Grace

Hi Carole.

Thank you so much for valuable information. Have you been able to decide for yourself?

May God bless you too.

Chacosh

Thank you grace. I think you have taken the biggest decision in this misfortune complication we all have. May God bless you and accompany you thru the process. My prayers are with you too. Keep us posted on further developements.

Chavosh

Your welcome. One side effects I have had were migraines for 2 episodes that lasted a few weeks straight, (knock on wood I am in my 5th migraine PAIN FREE week straight).

The other is the lumpiness on the operation area of the head. Not sure if all craniotomy's have this lumpiness but a quite few do. I posted this question a few weeks ago and many replied they had it. Skull is not the same smooth surfice like the other side being they remove it and need to use titanium screws & small plate to put it back in. As far as I know that is how a craniotomy is done. As for pain post op, I only had a few days of discomfort when I was home and I popped a percocet for it given to me by the surgeon. Not much though. If not for the migraines, all would be great. Keep in mind you might also have NORMAL temporary post-op, like weeks of severe energy loss, tiredness, short-term memory loss, etc. Everyone is different so others may experience more or none. Feel free to ask specifics if I left something out. By the way, short term memory loss is common with aging. Mine just got worse, lol. Jeanne

Thanks Chavosh! Blessings to you too. Grace

Hi Chacosh,

Yes, I've decided not to have any treatment at this time. You may want to read my story. I've had unruptured aneursyms for 42+ years. The ICA was spotted in a study 35 years ago but we don't have any precise measurements of it. The technology available back then was far more limited than what we have today. So, waiting and watching for another year, if God so blesses me ,won't be anything new for me.

I haven't written about it much but a key reason why I've decided not to have treatment is that I have chronic pain from Thoracic Outlet Syndrome (latest name for it). I've had chronic pain for more than 20 years. This pain has often been so severe that at times I thought I would die (I know that I've said my "last prayers" at least three time! It also zaps your energy.

The Thoracic Outlet pain is primarily nerve pain and while I have been able to "bear" it and hopefully it will be significantly reduced when I stop working full time, I cannot imagine voluntarily adding more pain in my life in hope of preventing something may never happen. Treating my annies will not improve the quality of my life today. So, when my husband and I consider this plus the fact that I have had aneurysms all my adult life and they haven't bled plus my doctor's statement that doesn't consider it surgery to be an "urgent" need (although he would coil it if I gave him permission), I'm comfortable with waiting. In addition, even if the 5mm aneurysm were treated, there would still be two aneursysms left!

Thank you for your blessings.

Carole

Thanks Jeanne.

How long was the procedure length.

How long did you stay in the hospital.

How long it took to resume the normal activities such as, exercising, driving. etc.

Thanks god you didn't experience other side effects,only 2 episodes of migrain.I am happy for you. I think skull issue in mornal and it will go away soon. By the way how ong after the surgery you went back to work.

Thank you again with my prayers for continuation of your health and leaving all this nightmare behind for ever.

Thanks carole.

Good decision. It seems you are very strong woman. God bless you.

Have you had any travelling during this long period and if yes were you been able to get travel insurance.

Am very sorry for your other heath complication. Isn't there any cure? It may look a silly question, that otherwise you haven't been in this chronic pain for such a long time. Again sorry abot that. let's keep the fingures crossed that the anni stays sleep for ever.

Take care

take care

Hi Chavosh,

I've done lots and lots of traveling but I've never taken travel insurance. Most of my travel has been business related so, I didn't really need it. I am considering trying to buy it if we do go to China later this year, though. It may be as challenging to get as life insurance and long term care insurance are.

The biggest part of the problem with chronic pain is that the doctors really don't know what causes it. Many people have chronic pain and much more severe than I do, so I count my blessings. A lot of my pain is related to heavy use of the computer. A lot is related to injuries that I had in a "minor" accident more than 25 years ago. And, per my PT, some is related to poor sleeping positions during multiple overseas flights

Once when I was undergoing PT, I was bemoaning the fact that the doctors appeared to only be treating the symptoms. The therapist told me that I was lucky that no one was proposing invasive surgery for me. I've come to appreciate his comments especially, since any surgery would involve my neck and great risk.

Yes, I will be praying that all our annies stay asleep for ever. Thanks for your good wishes.

Take care.

Carole

"How long was the procedure length."

I had to be at the hospital by 6 a.m. for bloodwork, prepping, etc. Then somewhere around 8 a.m they took me in. My husband said I was done by 12:30, taken to the recovery room, then I.C.U. and then to my own room. I can only base it on my husbands memory.

***************************************

"How long did you stay in the hospital."

I went in on Monday morning and home by Friday night.

*****************************************

"How long it took to resume the normal activities such as, exercising, driving. etc."

I have other health issues so to give you that answer would probably not be a good comparison. I can say I do not work, major back problems, so I don't exercise like an average person would. As for driving, I only drove locally for the first 3 weeks. I was able to do my housecleaning, care for my 3 dogs. Everything took me so much longer to do being I was very tired after 10 minutes due to post-op side effects. Like I say everyone is different and some do bounce back immediately or within days.

**************************************************

By the way, my 2 episodes of migraine were 24/7 for about a 3 week period straight. They were so bad that I had to go to the emergency room. The migraines took me down so badly emotionally that I literally did not want to live. On Christmas eve the 2nd round of migraines just stopped. So approximately 7 weeks out of 10 were with migraines (hell) and there was nothing to help me but tylenol, percocet. fioricet ( did NOT work). From what I read here headaches/migraines happen with coiling and craniotomies. Some don't get any headaches. You probably have to do a search on here for those specific people's opinions, but well worth it. That is how I heard about the Fioricet. Reading here has answered so much more for me because doctors either don't know or deny post-op problems and say the problem had nothing to do with the surgery. Why, I don't know. Let me know how you make out and what you decide to do.

Thank you so much for the info. I do pray for no more migraine ever on your way and no other side effects. I keep you posted on my decision.

God bless.

Hi, Chavosh - sorry you are having to make this decision - I know it is a hard one. There is one thing I did want to add. When you mentioned the risks of craniotomy, general anesthesia is used in both that and clipping (at least mine was). I had clipping and a stent. There are risks to both procedures, but like everyone here has stated, the neurosurgeons weigh everything when considering either surgery or none at all.

I wish you luck and health, I know it is a hard decision. The best decision you have made so far is to reach out to other "annie friends". They have been a blessing to me.

Sherri