Introducing myself

Hi, folks. I'm HNH, female, late 50s. I have an unruptured 8mm annie on the left internal carotid, and my ophthalmic artery originates FROM the aneurysm now.

It was discovered because my neurologist ordered an MRA of the Circle of Willis to see if there was a blood vessel cause for my neraly constant dull eye pain. My neuro-ophthalmalogist diagnosed the pain as trigeminal neuralgia. I've had the pain for 2 years, and it's getting worse. I also have extreme light sensitivity in the left eye.

I see a neurologist because I had transverse myelitis about 4 years ago with lesions in my c-spine, and I have had one or two brain lesions at a time, but very small ones. I'm being followed for possible MS.

So, neuro-opth says it's trigeminal neuralgia, but since there are no lesions on the nerves to explain it, that's why the neuro started looking for a blood vessel cause. They discovered what they thought was a 5mm annie and sent me to a neurosurgeon for evaluation.

The neurosurgeon wanted a very good picture, so ordered an angiogram. My follow-up appointment with the neurosurgeon is this week. The interventional neuroradiologist who did the angiogram told me it wasn't coilable, but he didn't say why. When I got the disc of images and reports, I found out it's because of the ophthalmic involvement. Coil the annie, block the opthalmic artery.

I took it to the neuro-ophth, and she thinks the eye pain is still TM and unrelated to the annie, because the location of the ICA inside the cavernous sinus is nowhere near the two branches of the trigeminal nerve that live in there. Also that there is no way to move or bypass the ophthalmic, and if I have to fix the annie, I will lose the sign in that eye. Furthermore, it wouldn't get enough blood to keep it plumped up, and it would probably shrivel in the socket. Ugh.

Neurosurgeon believes it can't be TM because it always has to be shooting ice-pick pain in his book.

Things I am anxious to find out this week: 1) Just exactly where is the annie related to the cavernous sinus and the optic nerve itself? 2) Does he think it is the cause of the pain and light sensitivity? 3) Did it grow 3mm in a few months, or was the MRA just not good enough to tell the actual size? 4) What's the risk of rupture at this size? 5) Does he think it needs to be clipped, and if so, does he know any way around losing the eye? If it has to be done, since one would have to sacrifice the eye, is coiling back on the table?

I'll probably ultimately end up getting a third opinion.

I'd be interested in hearing from folks who discovered their aneurysms at this size. Thanks for welcoming me to this community.

Again Welcome ... ~ and Hopefully you will get more diverse answers to your questions ~

Gotcha in my Thoughts ~ Colleen

Hi HNH,
Jo’s recommendation that you consider a doctor outside of Kansas City maybe a very prudent one since it seems that you have a very complicated case and none of the top hospitals in Kansas City are among the top ranked in the country for neurosurgery. :frowning:

If your circumstances permit, please at least consider another hospital for consultation if not also for treatment.

May God bless your with a competent and caring medical team. Best wishes to you.

Carole