Brain Aneurysm Support Community

Residual Thrombosed Aneurysm?

I just got the results from my 12 months scan and part of the conclusion reads:
“*Residual Thrombosed aneurysm in the coronal plane measuring 16.3 x 12.4 mm”.
It is 2 years since my aneurysm was stented so am surprised by this.
Does anyone know if this is normal so long after the initial treatment? it will be a while till i can ask my. doc.
regards,
W:)

Woofie, I have tried to “Dr Google” and can’t really find a clear definition. I have the word “residual” which if I am remembering correctly means it’s there but has been repaired. I see it as the leftover. I’m not finding a definition on thrombosis, that’s easy enough for me to understand and pass on as related to an aneurysm. What I’ve read appears that it’s related more to the large and giant aneurysms. Are you able to use a patient portal or call in to the doctor? I’m finding out just how lucky I am to get my image and been seen by Dr Quintero Wolfe on the same day.

I sure hope some other members know and we can both be enlightened.

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Thanks Moltroub. I really appreciate you hunting through Dr Google’s repositories. I too failed in my search.
I am expecting an appt with my neuro interventionist. I am not sure when as he and his colleagues are probably worked off their collective feet. I am very lucky as my specialist is one of the best in Australia although he works in the public hospital arena. Anyway this means I don’t like to bother him or his staff. So after Dr Google failed miserably I hoped someone on here had suffered similar. I will keep you informed if I find out more :slight_smile:

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I always consider it a good thing if the neurosurgeon isn’t immediately called in to look at the scan! I take it to mean there is nothing unexpected in the findings and that I am somewhere along the course of predictable healing.
I looked for info on Google Scholar (a tool for researchers). I tried to cut this research down to the key points. (Caution, I am not a doctor, but I have written about medicine as a reporter.)
Thrombosis is a good thing. Partial thrombosis occurs over time after stent placement with the goal of complete thrombosis.
In most cases, the aneurysm completely thromboses, there is no residual intra-aneurysmal flow, and the neck becomes covered by a neoendothelial-intimal layer (scar) which effectively seals off the aneurysm. Once isolated from the cerebral vascular system and sealed off, the aneurysm no longer carries with it a potential for rupture.
Flow diverting stents are placed to divert blood flow away from the aneurysm slowly, so healing occurs, and blood flow to that area of the brain isn’t immediately cut off. The goal is to divert blood flow along the course of the reconstructed parent artery, and to reduce blood flow in and out of the aneurysm. Partial thrombosis means that the flow hasn’t been completely diverted, but blood flow to the aneurysm has been reduced. This somewhat takes the pressure off the aneurysm wall during the healing
I found this statement about the path to complete thrombosis. https://journals.sagepub.com/doi/abs/10.1177/159101991001600204
“In most cases these aneurysms progressively thrombose over the ensuing six to 12 months, however the rate and extent of the thrombosis are difficult to predict.”

Don’t take this synopsis as fact. You should, of course, follow up with the doctor, maybe with just a phone call to see where he thinks you are on the path of healing. If they aren’t urgently contacting you, I would take it to mean there is nothing unexpected n what they saw.

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Hi Woofie,
My 2 year scan after coiling also had the word residual, and it scared me too. Luckily me neuro was not concerned and told me to be rescanned in 3 whole years! I hope this eases your mind a bit, and yours means the same thing.

Hey Woofie,
Firstly I agree with the other comments made here by other members
Residual = Leftover annie
Thrombosis = Blockage in the vessel
With some of those reports they can be really confusing/concerning in their language. I have often taken the reports to my dr and said “Please explain” to get a clear meaning.

From my understanding and research ‘Residual’ means the annie is still there, but ‘thrombosed’ means its blocked in the vessel, so there’s no blood feeding it and that’s a good thing. Its also a good thing that it has it’s size 16.3mm x 12.4mm. If that blockage clears for some reason (unlikely, but possible) those measurements may expand. Some medications can thin the blood and this ‘could’ clear the blockage but this is more common with partial thrombosis or a partial blockage as the thinner blood rushes past the blockage and can dissolve or dislodge portions of the blockage.
The ‘Coronal plane’ is an image slice of the brain running from the crown of your head to your bottom jaw, between your ears. I hope that makes sense.

But, all in all, I’d say that’s a good outcome written in the report.
Number 1: Its blocked
Number 2: It isn’t getting bigger.

Hope this helps
Merl from the Moderator Support Team

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This is excellent! Thank you so much for this info :slight_smile:

Thank you. You have eased my mind :slight_smile: I just hope it decides to shrink soon and quit taking up so much of my brain box grin

Thanks and it does help!!! Thanks to all of you :slight_smile:

Adding to what has already been said. I really don’t have enough info there to make an educated comment. Sounds like the doc is on it. There was coiling I assume? Recent data on the incidence of rebleeding after endovascular aneurysm therapy indicate that the rate is as low as 0.11% to 0.32%. In short there is seldom a reason to fix what ain’t broke. recovery is tough enough without worrying about abstract info. The treating doc has a better idea of whats going on than Doc Google (IMO)

TJ

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Thanks TJ and everyone :slight_smile:
I have an appt to see my neuro doc next week. Hopefully he will be able to tell me how long it will take for this big lump in my brain box to subside. Said lump continues to torment the battered remnants of my optic nerve. Not only is it the loss of sight, but also the weird images and hallucinations it causes due to the pressure on the nerve. Hopefully once the lump shrinks the optic nerve will quit complaining so much. :slight_smile:

Hi! Mine is 22 years old and still
Reads residual (old aneurysm found) and thrombosed (no blood flowing to it - it’s dying up. But still there). Sometimes I understand that the brain can absorb the aneurysm. Mine was the size of a golf ball and another the size of a large marble. Both are still there (residual) and neither have current blood flow to them (thrombosed). However, they both still cause me pain!

Best to you. May you find clarity peace and be pain free!
Dr. Ruth

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Thanks for your reply. It sounds pretty depressing :frowning: Can’t the thrombosed lumps be removed or dissolved?

There can be many variables to this question Woofie. Where is the ‘lump’? Is it near the surface of the brain, if it’s deeper within the brain the damage they could cause in going in may outweigh any benefit. Open brain surgery has a lot of risks and if they can avoid opening the skull, they will. There isn’t a lot of room within our skulls for them to go poking around in there without damaging the surrounding structures, so although removal sounds simple enough, the processes of doing so maybe far from simple.

I know, for myself, the recovery from a craniotomy has been FAR, FAR from simple. The medicos may have dealt with the physical cause, saying it’s been managed but the flow on effects and impacts have been MASSIVE. I have spoken to the surgeon about this and he was fairly blunt in response “we could have left it and you could have died or we operate, possibly save your life, but you have some impairment. Which would you rather?” Initially I thought he was a bit rude in saying this, but that is the blunt reality I probably needed to hear. They have to work on a ‘risk vs benefit’ theory. The less risks the better.

Merl from the Moderator Support Team

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Thanks Merl :slight_smile:
I saw m nice neuro dude yesterday and yup, I just have to learn to live with my lump. On the plus side the visual hallucinations it engineers are more entertaining than a lot of what is on tv ! grin
W :slight_smile:

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Good to hear Woofie.
Eventually we find a (semi) ‘normal’. I’m still not back to where I was prior, but I’m better than I was post surgery. So this is my semi normal. We learn our new aches and pains, which ones are normal, which ones are a concern and which ones are an ‘Act NOW!!’ We learn our new limits and how to best manage within them (that’s not easy by the way).
Initially, every ache, every pain and my wife was ready to hit ““PANIC”” and I’ve had a few where her concern was warranted (although, I’d never tell her that :smile:). I try to minimise things so she doesn’t panic, but more often than not she can read it on my face. I can’t always hide the agony. Damn it :grin: But we do learn to move on as best we can.

Merl from the Moderator Support Team

Good one Merl! Instead of “semI” how about the “New Normal” ? Like you, the first 12 months after treatment were crapola - ie 12 months of sudden dark were terrifying - so much so that I told my Spouse to hide the keys to the gun safe.
Slowly gaining sight was a miracle! Yes, now I have only a fraction of the sight I had before, but that fraction is better than the 100% I had before. This means I no longer need glasses for reading my PC screen. I only need glasses for small print!!!
According to my nice neuro doc, the odds of complications from treating a non burst aneurysm is 5%. Unfortunately I (and Merl) were ones of the 5%. )Now, for you newly diagnosed and frightened and looking for answers and stats, just remember that 95%, according to my doc have no negative nasties at all )