Should I have surgery now?

  • I was diagnosed with a 5.4 mm anterior communicating artery aneurysm 2 months ago. Elective surgery - surgeon said I could opt to have surgery now or wait a year and have an MRI done then. A friend “had” to have surgery when her aneurysm was at 5 mm. I’m scared if I wait then it may rupture. I’m leaning on having it coiled now. Any thoughts?
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Hey Janet,
An annie of 3mm or less is considered small. With an annie of 7mm surgery is usually recommended but all of this can be dependant on the location. In between the 3mm & 7mm is basically at the neurosurgeon’s discretion, hence you being told elective. You could opt for a 2nd opinion, but this can confuse an already stressful situation and if you’ve already made the decision to have it coiled now, then I’d say do it. The plus here is that you do have time to consider your options. Some dr’s will say ‘wait and watch’ others will say ‘operate now’, it really is a decision that is between you, your family and your surgeon.

Merl from the Moderator Support Team

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Thanks for the reply. It’s very hard when the decision is left up to me. The waiting is very hard. I find I am going into a depression and I’m not the same person I was before the diagnosis. This is why I am now strongly leaning towards getting it done and over with. That being said, no one can guarantee what the outcome will be.

I couldn’t agree more. Often the medicos give minimal assurance, then say “you make the decision”. I have found that part of the reason they don’t give any great assurance is so that if the desired outcome is not obtained they cannot be held responsible, like saying “Well, don’t blame me…”, which doesn’t fill us with great confidence.
Something else I can assure you of is that the stress of waiting is normal, very normal in fact. The neurosurgeons deal with this sort of thing on a daily basis but for the individual this sort of thing is far from normal and this is why I say “…it really is a decision that is between you, your family and your surgeon.” Use all the supports you have available to discuss your options and concerns because, let’s face it, we are talking brain surgery here. This was one of my biggest hurdles ie I am me now, but what will I be post surgery?
Another suggestion here is aim low for your recovery. I didn’t. I’ve now had a few neurosurgeries and initially my view was post surgery I might need a week to recover, then back to work and I pushed myself to get back to ‘normal’. But that ‘pushing’ has done me more harm than good. I was so very disappointed when my week off work turned into a month and this sunk me into depression badly. After my third operation I made the decision “…It takes as long as it takes…” this lessened the pressure I placed on myself and that was a huge plus. My last surgery, No.6, has really done me in and no amount of pushing has worked. I’ve now been told I’m unlikely to ever return to my former work role and this fact has been fairly devastating, but I can now look back and think I could have been put out of commission with the initial operation. So, as I say “Aim low” at least that way anything more is a bonus and emotionally/mentally it is less of a burden on us. I’d also like to say here that comparing one individual’s exact outcome to another’s is impossible as each person’s surgery is very individual. Even comparing my own surgeries is difficult as from my experience each surgery has been totally different from the one before.

But whatever the outcome be kind to yourself.

Merl from the Moderator Support Team

Wow thanks for that response. Very helpful. How big was your aneurysm when you had surgery? What was the location? Was it elective? My follow up appointment is next to give a decision. I am aiming low, like you said, but that is what is scaring me the most. Why did you have 6 surgeries??

I meant to say my surgery is next Tuesday.

Hey JanetJ,
My situation is not an aneurysm, but certainly brain related. I have been involved in a motor vehicle accident many years ago, which has caused a brain shift and a disruption with the flow of fluid and a growth to develop. The location of my condition is centred within the subarachnoid space, right in the centre of my brain. My initial surgery was to place a shunt to drain the fluid, but this did not resolve my issues. Each surgery since has been to ‘fix’ the problem, but in reality has only caused further issue. The growth itself cannot be removed as this could cause further, more debilitating problems ie blindness for one, so for me it is an ongoing situation that I have very little to no control over. Each surgery has had its own issues both in terms of surgically and recovery, so to be saying that for surgery X, symptoms Y are the result is impossible. No 2 brains are wired exactly the same way, so nor can the resulting symptoms be exactly the same.

Merl from the Moderator Support Team