MRA, CTA show possible 1.3mm ICA outpouching

I had an MRA/MRI performed in August 2018 and the results showed a possible 1.3mm outpouching. The neuro radiologist suggested a CTA to look at the area in question closer. At the time he concluded it was likely to be a normal variant caused by the contour of my ICA. I had a second opinion with a neurosurgeon he stated he thinks I do have an aneurysm. I decided to wait 6+ months and repeat the MRA. I just repeated the test and the results still show the possible outpouching in the cavernous segment of the ICA. The neuro radiologist stated he’s not sure if it’s a normal variant because a infolateral trunk is common at the area in question and therefore could be in my case as well.

I’m a 39 year old male. I workout 6 days a week - weight lifting and run between 6 - 10 miles a week. I eat incredibly healthy and do not smoke, drink any alcohol or use drugs. I’m really confused and not sure what to do right now.

If this were an aneurysm is it likely it would have grown by even .1 mm over 7 months? Is it possible this is a normal part of my anatomy? I was told this is below my brain so does that mean it’s less likely to cause serious impairment or death IF it were an aneurysm and burst?

Hi, it can be outpaching ,anatomy … if aneurysm , I am not sure it will change size in 6 month … usually if they grow it happens slowly … I think you are doing right thing keeping an eye on it in 6 months, then it can be once a year on once in 2 years ( the doctors will know)
In my case I had opposit situation radiologist on MRI saw an aneurysm . Neurosurgeon looking to MRI was more sure it’s anatomical shape , but still scheduled an angiogram . But in angiogram he confirmed that it was an aneurysm .
Regarding location , as I understood there are some less dangerous , to be sure it’s better to double check with doctor the location and risk if it’s aneurysm …

In my experienced five years, the Radiologist always reads my scans differently than the Neurosurgeon. But I go with the Neurosurgeon because she is the one doing the angiogram. Although I don’t take angiograms lightly, per say, perhaps it would be the only way for you and the doctors to be sure. Variants in arteries are extremely common.

Here is a paper that explains all the different types of imaging available to the specialists.