New symptoms 3 years after rupture

Hi fellow survivors!

I’m 36 years old and had a cerebral aneurysm rupture 3 years ago in the left side of my brain, causing third cranial nerve palsy. It was successfully coiled, but caused permanent Mydriasis to my left eye. During this process, they discovered another aneurysm on the right temple. It’s only 2cm, so they left as is and monitor regularly. For a long time after this I felt like a ticking time bomb, never knowing when/if it would also rupture. I am still battling with anxiety, depression and PTSD, but have begun to get a handle on it. However, recently I’ve been having new symptoms including fatigue, memory loss and the inability to focus. I’ve always been great at my job and able to focus and stay productive all day. But over the past few months I can’t keep my thoughts from racing and stay focused for more than a couple minutes. Has anyone else experienced the memory loss and focus issues? If so; how did you deal with this? The doctor has me on Lexapro and Wellbutrin which are definitely helping with the depression, but not the focus/memory loss. Any suggestions would be much appreciated.

Thanks, Dana Lee

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Welcome DanaLee!

Focus, memory retention, fatigue and your other symptoms are issues most of us have after a SAH. But since you said some were new to you, it makes sense to talk to your doctor.

I always get confused when doctors order two meds for the same thing. Wellbutrin and Lexapro are both antidepressants. Sometimes docs forget they put us on drug A and decide to give us drug B but forget to tell us to stop Drug A. You need to ask your doctor about this. If you have two different doctors prescribing two different meds, start with your PCP. Once I had some 3rd degree burns on my leg, my regular PCP went on vacation and I had his stand in for the cleaning. The stand in told me to wash the burns with a special cleaner. I read the warnings, called the stand in and was told he was the doctor, I was not. I ended up with gangrene. My PCP was livid. Luckily, my PCP saved my leg. That PCP also taught me it was okay to question doctors and their treatments. My current PCP wouldn’t put me on Wellbutrin because of my rupture, saying it’s contraindicated with head injuries. She wants me to stop smoking.

First thing I always ask is are you working with a licensed therapist for the depression? Meds alone can’t do everything, we have to put effort into learning new skill sets or tools.

Also I would look at the length of time you’ve been on the meds and if some of your symptoms started after using them. Have you discussed this with your doctor? Did you read the side effects of the medications that are supposed to be attached to the new prescription? I have had pharmacists catch incorrect meds and have either told me they refuse to fill one until I talk with the ordering doctor or have called the doctor themselves. It’s a good reason to stay with one doctor and one pharmacist.

It all boils down to call your doctor and let them know about your symptoms. If all these symptoms started before the medication and are getting better, see a licensed therapist. You may need to see a psychiatrist. A psychiatrist is better trained then a PCP in medications that alter moods. It is after all their specialty. Get back with us and let us know how it’s going!

Welcome! It sounds like your rupture was in a similar location as mine but mine was behind my right eye. I also have permanent mydriasis and double vision caused by third nerve palsy. You didn’t say how they were monitoring yours. Mine was coiled but 3 months after they did an angiogram and discovered my coils had compressed leaving a remnant aneursym. That was watched for the next 3 yrs by MRA’s. What the MRA’s didn’t show was that the lining wall of the remnant was getting thinner, even though the size was stable. Also the MRA’s didn’t show that the coil mass had blocked and killed off an artery and had fused to my nerve so with every heart beat it pushed it against other nerves. I had to go to a new doctor to find out all of this and get it fixed permanently. So I always recommend getting a 2nd or even 3rd opinion. And maybe get a follow up angiogram if they haven’t done that that since the rupture. New symptoms should always be investigated, especially since you have a 2nd one being watched. I wish you the best!

viv22, What tests did the new doctor do that discovered what exactly was going on? A new angiogram?

My initial doctor just ordered MRA each year and told me to “not worry about it” and that my symptoms were not aneurysm related. At the 3rd year if it still showed stable he wanted to move it to 5 yr MRA. I was not comfortable with that so I went to a new doctor. I had learned a lot in those 3 yrs since the rupture and found one of the best doctors. The new doctor felt I was at risk and it should be repaired. So the tests I had after initial rupture were: angiogram during the coiling 2013, CT scan before leaving the hospital 2013, angiogram 3 months later that showed the remnant 2013, MRA each year next 3 yrs 2014-2016, then 4th year angiogram 2017 that showed the blocked artery. The clipping surgery in 2017 is where the doctor saw that the walls of the remnant aneurysm were very thin and at risk of re-rupture and that the coil mass had fused to the nerve (this was not visible on the MRA or angiogram). My next follow up is a CTA this Dec (3rd yr post clipping). If all is good I won’t need another follow up for 10 yrs. Per doctor, I have to have a CTA now because too much metal in there that would prevent good visibility using the MRA.

Even if you like your doctor and stay with him/her, it is still good to cover all your bases and get another opinion, preferably one where the doctor does both clipping and coiling/stents if you can find one that has experience with both (my new doctor did). In my case if I had not changed doctors when I did, mine would have ruptured again.

Your symptoms do not mean anything new is going on with either of your aneurysms, and probably not at all. I just have a hard “lesson learned” for my particular situation and I want everyone to be as safe as possible.



Hi Viv, after my rupture I went to CPMC in San Francisco every 6 months for angiograms. I had my last one January of this year. I got the all clear and was told I would just need yearly MRIs and another angiogram in 5 years. I think I might get a second opinion. I love my doctors, but you do make a good point.

Hi Moltroub,
Yes, the doctor knowingly put me on Lexapro and Wellbutrin. The pharmacist ok’d it as well when I double checked with them. I see the same PCP and same pharmacy every time. I also have had bad experiences with fill-in doctors, so I make it a point to keep it all with one now. I’ve reached out to my neurologist and a neurosurgeon and told them both about my new symptoms. I also just has an MRI since posting this. They say everything looks good. But I think I’ll get a second opinion, at least for my own peace of mind.

Thanks for the great detailed explanation viv22! I’m fortunate that my Neurosurgeon does all types of aneurysm procedures. For some odd reason, she has always known what works for me. I like to think that she can think outside the box. She recently removed a large tumor from a friend of a friend and he is doing remarkably well.

I’m so glad you’re staying on top of your health DanaLee! It’s something we all have to do. I think most of the doctors today don’t mind us questioning them. It is after all, our health, and it’s how we become educated in our issues.

Just a thought, as it’s easy to attribute every symptom to our aneurysms - could the fatigue be a symptom of something else, since you said it’s new? And the memory loss too even, or focus. I’ve been battling fatigue and discovered I have iron deficiency two years ago (my docs did not, I did, and made them test me to confirm), but taking supplements didn’t completely stop the fatigue, just lessened it. Now I’m seeing a naturopathic doctor and she tested my adrenals and found I have extremely low cortisol. I’m taking an adrenal tonic and feel TONS better, as well as some DIM/I3C supplements. Like I said, just some thoughts to think outside the box.

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Thank you, now I know I made the right decision to get a second opinion.

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