Sixth Nerve Palsy affected by Brain Aneurysm (help)

Hello

I am a 28 year old male living in Singapore and have been diagnosed with Brain Aneurysm recently which is affecting my sixth nerve palsy causing me to have double vision (my right eye is looking more inwards everyday). Currently, I am not under any treatment as the aneurysm is too near the brain stem to do any surgery.

Is anyone having the similar situation as me? How are you coping with it? What question shoud I be asking the doctor?

A little about me: I am working as a food technologist which is affecting my job slightly. I have recently proposed about 3 months back and am afraid this problem will causing problems for my partner in the future especially financially.

I am trying to live life as normal as possible so to reduce any worries for my parents but its getting harder and harder each day to act as if nothing is wrong.

I don’t smoke, drink or do any extreme sports that could have caused this. I even went to the gym for a year to change to a healthier lifestyle and this happened. Questioning everyday why this is happening to me.

My ability to cope with this situation wanes with each passing day.:sob:

The quality of medicine in Singapore is very high. Also, I believe that medical care is free; however, you may want to seek a second opinion in Medical Centers (like UCSF, or NY/Boston/Toronto area) specializing in treating Aneurysm whether it can be operated or not. What is the location and size of aneurysm? In my case, it was a ruptured aneurysm (10mm by 8mm fusiform) at the vertebral/PICA juncture which is located near the brainstem Pons/Medula. Unfortunately, the SAH bleed filled the space between cerebellum and brainstem. I have chronic vertigo, nymagtus, double vision and partial hearing loss where the VIII vestibular/cochear nuclei was affected. The treatment is with prism glasses (double vision) and Neurotin. The treatment only manages the double vision and vertigo.

I would ask the following: 1) What is the size and location of the aneurysm, 2) why is surgery not an option either by Endovascular or clipping?

The reason for the second opinion is that if it ruptures, the probability of complications, disability and fatality are very high.

Best of luck

Hi

Thanks for the information. Medical Care is subsidized for public hospital but if going private, it will not be subsidized at all. I shall ask for a 2nd opinion. Is it possible to get the medical report from the hospital? Like the MRI scan and such, as I am not sure whether would it violate any medical law.

Mammothboot, not sure about laws in Singapore, in the United States, the records legally belong to the patient. However, the facility can always charge the patient for making a copy. They don’t typically charge here if you are having your records sent to another doctor. I’ve even had doctors give me my records as they copied what they wanted and didn’t want to have to store the rest.

Have you spoken with your specialist?

Here’s a basic breakdown of the arteries, http://www.bafound.org/about-brain-aneurysms/brain-aneurysm-basics/understanding-the-brain/

I think 2Fight is asking about your aneurysm location because it’s how we identify with others.

In the meantime, do what you can to relax. Don’t let this rule your life, be proactive, make daily, weekly, monthly goals. Talk to your partner about your concerns with the relationship. communication is a great way to relieve stress, even if what’s being discussed isn’t what you want to hear. At least it’s out there and not bottled up.

Good luck and keep in touch!

Mammothboot,

I agree with Moltroub. I would start getting the NeuroSurgeon’s report. The report should indicate the location, size and shape. I would request the MRI records from the hospital. For Singapore law, I would ask the hospital and your initial NeuroSurgeon’s office whether there are any restrictions but I would assume that records legally belongs to you.

The reason for locating a clinic that is regarded as “Center of Excellence” for Aneurysm is typically they would have several NeuroSurgeons on staff with their own specialty. Depending on their specialty, they may recommend endovascular procedures (coiling, coiling with stents, Pipeline) or craniotomy (clipping).

I know that it is really scary and your unruptured aneurysm is already having some affect. But, it is a blessing as it was caught. Now, it is time to do your homework. Please ask more questions. There are a lot of resources on this site. Also, read other posts with folks with unruptured aneurysm. You can see their strategies on addressing it. Best of luck to you.

I am not a doctor. I cannot assess anyone’s condition as I am not qualified to do so. In reading about the Circle of Willis (COW), it is stated that the COW and the Optic Chiasm share real estate. I have seen many percentage estimates of cerebral aneurysms being around 80% in the COW. If the COW is the most likely location for aneurysmal development and the Optic Chiasm shares neighboring or relative real estate, it should be accepted that there is a significant likelihood that visual complications would result from the development of an aneurysm of the COW. My physicians have conveyed to me that there are 12 sets of cranial nerves, and 6 of these 12 sets are responsible for our ability to see. There are special lenses for glasses that are available on occasion that can help with Diplopia. An ophthalmologist may be able to help with reducing the effects of the double vision. Never accept the first opinion of a physician, always get a second opinion. Good Luck and best wishes.

hi I believe you need a specialist, i forget what they are called? neuro opthamologist i think? Was your aneyrysm ruptured?