Were you able to find a neurosurgeon to treat your PICA aneurysm? I was just diagnosed with a small PICA and live in Maine. I am struggling to find who is the best in the area that treats these.
I am see Dr. Adel Malek on 03/05. It’s a start and figure I have time to get several opinions.
Thanks
I just was diagnosed with a small PICA aneurysm. It’s quite stressful and I have yet to see a neurosurgeon. I think I have made a mistake reading about how complicated surgery or coiling can be for these types of aneurysms.
I’m glad I found this site.
Hi, you ha a very small PICA BA. I have heard that Dr Malek is very good. Dr Ogilvey is also a very experienced well know NS with many years of experience. Mine is 8mm and not repaired yet. I wish you luck. I would be very surprised if any doctor would want to treat a 1 - 2 mm. I know many people will say that their’s ruptured at only 2mm but our location is very rare to treat. Good Luck to you!!
thank you for the reply and the additional name. Yes it’s very small. Which I am thankful for. I certainly have time to do some research about it. I would assume I will be in the monitoring stage at this point.
I think reading about how rare these are and how they can be trickier to treat has me more worried. I’m only 43, so the chances of me needing some sort of intervention is probably high. Maybe I will be lucky and it will not get larger.
I figure I will start with Dr. Malek and see what he says. I will definitely look into Dr. Ogilvey as well.
Just from your experience with this so far, are they recommending clipping or coiling? It seems like with these types the jury is still out on the best way to treat them. Mine is located where the pica artery meets the vertebral artery.
Well the only upside on the location is it’s easier to reach going the clipping route. I was first told by all doctors (I visited many) that they would try coiling. On my last CT with dye the Brigham & Womens said they all decided it would be much safer if it was clipped. Initially they also said coiling. Remember mine is quite large and the chances of rupturing while treatment are pretty great. Your BA is the same exact location as mine. I just don’t think they will want to rush into doing anything with yours being that small unless it grows within 6 months, or you smoke or have high blood pressure. All those extra conditions weigh heavy on your treatment. Please keep me updated and let me know what Dr Malek has to say. I’ll be thinking about you.
Thank you so much. I agree with you, I think it will be a while before anything needs to be done, if at all. I’m the worst “what if person” so this is challenging for me. I just wish I didn’t have it at all, but obviously that is not going to happen.
Are you having surgery soon? Keep me posted as well.
Thank you for all your help.
Allison
Hi Alaqualia,
Welcome to this unique fellowship. My husbnd had a ruptured pica aneurysm repaired 23 months ago. As you have no doubt read, pica aneurysms are rare. Ther are several folks on this site who have had pica aneurysms repaired. Stay strong, you are not alone. So many surgeons are tremendously skilled and can help. Wishing you every success.
My PICA, which also is in your location, was repaired with a PED device known as the pipeline flex. Mine had a wide neck at 4 mm. Most of the doctors I visited, recommended clipping as a first choice. One recommended coiling, and one even recommended that I could just monitor it even though at the time it was thought to be 10 mm. I, like Lady, had many different opinions from many different types of doctors. For basically six months, I made it my life’s work to research and figure out the best route for myself. You are in a good geographic area and I believe going to a major city to a hospital and surgeon that deals with lots of aneurysms is definitely the way to go. Living in the Northeast, I researched hospitals that were ranked in the top 10 for neurosurgery in the US World and News Report and then picked a couple that were within traveling distance by car to seek opinions. I have eventually chose my surgeon , Dr. Howard Riina up at NYU because his name was mentioned twice on this site as well as was given to me by a neurosurgeon that was on the advisory board of another brain aneurysm site. He also specializes in both clipping with open brain surgery as well as various endovascular methods. I took a risk and decided to go with the pipeline embolization device rather than the clipping and I’m glad that I did. Different doctors have varying opinions on when they would like to do surgery. Some wait until it is 5 mm and some believe, depending on the location and size and other characteristics, that smaller ones should be repaired sooner. It is important to have monitoring done on the same machine , and a good one , so that you can see if there is actual growth or not. My initial MRI showed nothing except for a few images after contrast was administered and it was measured at 5 mm. I was then told to go to one with a stronger magnet and then the second one showed 6 to 7 mm, Then angiogram showed 9 to 10 mm, and in actuality during surgery it was measured at 7.5 mm. So when you’re talking about millimeters , there can be some variation in the way your aneurysm is measured. Since yours is small, you do have time to do plenty of research. I like you, was in disbelief when I found out I had an aneurysm and one that was rare on top of everything else. But it is possible to have it repaired and recover. I have a few deficits left, but nothing major that I cannot handle. Let me know if you need any other information and how your appointment with Dr. Malik went. Keep us posted, we’re all here to help!
Hi Alaqualia,
My Aneurysm was located at the vertebral harboring the PICA probably similar to Lady. It was a large fusiform aneurysm 10mm by 8mm. But, in my case, it ruptured. I am not going to talk about the consequences of the rupture as it will just give you stress but I can say that I survived and independent even though I am still working through several disabilities. By sheer luck, my ambulance took me to my local hospital where my excellent Neuro-Surgeon is skilled in both traditional (clipping) and endovascular methods. In my case, he basically coiled the aneurysm whereby it redirected the flow preserving the PICA. I just had my 3rd year Angiogram and it came out positive where I do not have need additional angiogram for the rest of my life. My suggestion is having opinions of both Neurosurgeon skilled in Endovascular as well as traditional. It looks like your found great Neuro-Surgeons. It is important to go to a facility specializing in Aneuryms like UCSF, NYU, Boston. Hope the best for you. Consider yourself to be the luckiest person alive as it was caught before rupture. How was your visit with the NeuroSurgeon’s office?
I am trying to consider myself lucky as well. It is certainly a little daunting. I did see Dr. Malek. He said the MRI I had was not great quality. He is not sure I have an aneurysm at all and is having me come back at the end of May for a better quality MRI there.
He did talk about an angiogram as well, but felt like we could hold off for now.
So more waiting and hoping!
I am wondering why the doctor does not suggest an MRA or a Cat scan with dye.
I had a MRA and MRI with and without contrast of the head and neck. They basically cannot tell if it’s a true aneurysm or not. The neurologist I saw also said the MRI was not the best quality. So I go back to have it all done in a couple of weeks. He said insurance would most likely not pay to have it done sooner as the area they are looking at is quite small.
So I will keep you all updated after my next MRI.