Questions to ask at first follow up at 6 weeks

6 weeks Post Op and im going back to see neurosurgeon this week for the first time and am unsure what i should ask.
I experience a fair amount of electrical tingling, at different times; some have suggested that this is less common 6 weeks post op.
I had a MCA clipped and My dad died of a SAH at 50 so they took no chances with mine.
I know i have memory issues and sensory issues and these electrical tingling feelings but im just so happy to be here that i honestly havnt thought to much about what to ask and where to from here. All my energy has been to get through it any suggestions will be much appreciated

My suggestion is to make a list. Post neurosurgery I had memory and sensory issues too. But when you say ‘sensory’ that can mean almost anything. My dr’s wanted a more refined definition. For example I had a wooshing sound in my ears when walking, flashing lights like stars in my eyes, floating things in my vision, tingles in my hands and feet.
They wanted me to keep a diary to show frequency of ‘sensations’ was it occasionally, was it daily, was it hourly. Initially they said “It will pass” but when it didn’t they investigated further, sending me to an ophthalmologist, audiologist and a pain clinic. Having a diary of it all helped in showing these things weren’t just a once off occurrence.

Merl from the Moderator Support Team

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Hi! I agree with the person above me. Definitely make a list of questions you have before going in. On my list I asked if certain activities were safe to participate in. For instance, I asked if it’s safe for me be taking a hot yoga class in a 90 degree room? Are inversions fine can I go upside down? Will altitude affect me (and yes I have learned it does affect me more now than before)? These were some of my questions, but I’m sure you’ll have your own. Best of luck!!

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Ok So i had my first 6 week check up. I already had my scan confirming that the surgery was 100% sucess.

A bit of background, 45 non smoker have smoked socially, like a glass of wine with dinner, blood pressure only occasionally high. Dad dies of SAH at age of 50, 25 years ago dad smoked for 17 years and had high blood pressure.

The surgical team and surgeon all saw me.
They said i wa doing as to be expected for someone that has had a “controlled brain injury”

Questions summarised

tingling electrical feeling- nerves growing
Memory- to be expected many experience it, should return within 4 months
Eye droop- should return in 4 months
Lethargy - surgery, anesthetiser, brain is tired an lowish iron. Told me to eat more iron rich foods and should improve in 3-4 months
should siblings get checked., yes they should discuss with dr, high blood pressure, smoking status, alshol intake and any drug use is higher risk factors plus 2 immediate relatives with aneurisms. Told me its less likely in my children and not worth putting my son through the process ( he has autism)
Do i need follow up scans? - **She said its not necessary as I didn’t have an SAH and im not a smoker and my blood pressure is under control and that apparently research shows its not likely to develop after 45 without those risk factors. ** thoughts anyone??? This is the part that worried me.

The surgeon has been brilliant and i do trust her but so many people have mentioned about having others occur so please tell me if you have had any further aneurisms occur after the initial one, what age are you and whether you smoke, have high blood pressure drink, have others in family with it.

PS also sending me to neuropsychologist to assist with memory and being more emotional .

Merl is right on! A few things different from my directions with family was told to tell my nieces and nephew. One great nephew has been having some type of brain issue, I forget which one, but his last check up, even his Neurosurgeon orderd a more inclusive MRA. My niece could explain that, I can’t as I don’t know the difference. I’m guessing it’s more inclusive of the entire artery system and not just the bit they usually look at. I have no offspring. Also make sure to stay hydrated, it helps in ways too numerous to explain. After my coilings, I had to increase protein intake and drink Gatorade. I ruptured so it’s a whole different game with everything else.

I did 23andme genetic testing years ago when they were a really helpful service, before the medical industry tried to discredit them and shut the down. They can still be of help to you, but it will take more work on your part. There are some genetic markers for aneurysms, cerebral aneurysms, and abdominal aortic aneurysms. You can find out if you have those markers, and then find out if your family members have them. Believe me, spitting in a tube for genetic testing is completely non-invasive, a lot less scary than putting someone through a cerebral angiogram just to take a look around.

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Mary, do you mind sharing the source of the genetic markers known? I remember some teams were suggesting further studies, back a couple years ago or so. It would be great if the study had been done and was repeatable! All I could find is “Until now, there are no diagnostic tests for specific genetic risk factors to identify patients who are at a high risk of developing intracranial aneurysms”. Here’s the link to that 5 year old study https://www.ncbi.nlm.nih.gov/pubmed/23399038

Stand by, I’ll go see what is still available at 23andme first, then look at my old reports.

I know this isn’t cerebral, but I figure, where there’s smoke there’s fire.

Blockquote

In this study, researchers compared more than 4,500 individuals who had experienced an abdominal aortic aneurysm (AAA) to about 38,000

individuals who had not. All study participants were of European descent from Iceland, Europe, North America, or New Zealand. The researchers found that each copy of an A at rs7025486 was associated with 1.2 times higher odds of AAA. When they examined the variant’s effect on other cardiovascular diseases, they found that the A version of rs7025486 was also associated with slightly higher odds of early-onset heart attack, pulmonary embolism, and peripheral artery disease.

Blockquote

Gretarsdottir S et al. (2010) . “Genome-wide association study identifies a sequence variant within the DAB2IP gene conferring susceptibility to abdominal aortic aneurysm.” Nat Genet 42(8):692-7.

Give me a few minutes to get some more study citations

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Thanks Mary! Isn’t it amazing the conflictual information studies can present!

Yes, that’s why I went back and added some specific info about that particular study. For example, the test subjects were entirely of European descent.

There is another that is a marker for both aortic and cerebral aneurysms. I’ll get that now.

This study compared 2,836 abdominal aortic aneurysm cases and 16,732 healthy controls from Iceland, Belgium, Canada, the United States, the Netherlands, the United Kingdom and New Zealand. The authors found that compared to the AG genotype, the GG genotype increased a person’s odds of having this type of aneurysm by about 1.3 times, while the AA genotype decreased a person’s odds by about 1.3 times.

Helgadottir A et al. (2008) . “The same sequence variant on 9p21 associates with myocardial infarction, abdominal aortic aneurysm and intracranial aneurysm.” Nat Genet 40(2):217-24.

Okay, so here we see the cerebral aneurysm part of the study mentioned above.

The authors compared 1,134 people with brain (intracranial) aneurysms to 15,481 healthy controls from Iceland, the Netherlands and Finland. The authors found that compared to the AG genotype, the GG genotype increased a person’s odds of having an intracranial aneurysm by about 1.3 times, while the AA genotype decreased a person’s odds by about 1.3 times.

Helgadottir A et al. (2008) . “The same sequence variant on 9p21 associates with myocardial infarction, abdominal aortic aneurysm and intracranial aneurysm.” Nat Genet 40(2):217-24.

This study frames the issue from a “glass half full” perspective.

A 2008 study of about 9,000 Europeans found that each G at rs9298506 reduced a person’s chance of having a brain aneurysm. People with one G at the SNP had 0.7 times the odds of having an intracranial aneurysm compared to those with the AA genotype. People with a G at both copies of the SNP had 0.5 times the odds.

Bilguvar K et al. (2008) . “Susceptibility loci for intracranial aneurysm in European and Japanese populations.” Nat Genet 40(12):1472-7.

Same study but a different gene, hence the term loci in the title

A 2008 study of about 9,000 Europeans found that each A at rs911271 reduced a person’s chance of having a brain, or intracranial, aneurysm. People with an A at both copies of the SNP had 0.82 times the odds of having a brain aneurysm compared to those with the AC genotype. People with a C at both copies had 1.27 times the odds compared to those with the AC genotype.

To save us all time, here are the remaining loci mentioned in the Bilguvar study.

  • rs1429412 (European)

  • rs10958409 (European)

  • rs700675 (Japanese subjects)

  • rs1333040 (Japanese)

So, I have the worst or not great markers in most of these. I have a single cerebral aneurysm (to date). Several members of me family did 23andme and found that none of them have as many bad markers as I have. I recommend to my female relatives that they tell their ob/gyn about me, to help them make more informed decisions.

Here’s the abstract of that study:

Recently, two common sequence variants on 9p21, tagged by rs10757278-G and rs10811661-T, were reported to be associated with coronary artery disease (CAD) and type 2 diabetes (T2D), respectively. We proceeded to further investigate the contributions of these variants to arterial diseases and T2D. Here we report that rs10757278-G is associated with, in addition to CAD, abdominal aortic aneurysm (AAA; odds ratio (OR) = 1.31, P = 1.2 x 10(-12)) and intracranial aneurysm (OR = 1.29, P = 2.5 x 10(-6)), but not with T2D. This variant is the first to be described that affects the risk of AAA and intracranial aneurysm in many populations. The association of rs10811661-T to T2D replicates in our samples, but the variant does not associate with any of the five arterial diseases examined. These findings extend our insight into the role of the sequence variant tagged by rs10757278-G and show that it is not confined to atherosclerotic diseases.

Meaning no disrespect, because I really appreciate the effort you took on this, but if a study from 2013 is still suggesting but cannot prove it, genetic marker, then how does/can the 2008 study compare to cerebral aneurysms?

I will try to find newer studies but I’ve failed in my mission to stay on task today and laundry calls. I’ll get back if I find a study from the last three years. It’s been my experience that newer studies are more reliable due to the ever growing data gathered. Has this been your experience as well?

Mary 2014, what country are you in? Don’t know if they have that here in Australia but i will certainly look into genetic testing instead.

Wow thankyou so uch for all this information. I’m a little overwhealmed with all this details but it’s awesome to see they are looking into it. My niece was born hemiplegic as she had a stroke in utero. She ha a number of health issues and she did have one gentietic testing and so did my bro and his wife. It will be interesting to see whether any of these markers do come up for my niece. I’m certainly interested in doing this. Ill look into this further.

Scientific research - especially in genetics - is a cumulative effort. Every new study that is well run adds to the body of knowledge.

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Anniesurvivor, I live in the U.S. 23andme is an international organization. There are lots of places where you can get your genome. I recommend you comparison shop and wait for a sale.