Small Aneurysm - John's Hopkins

Hi there
I have a 2.5 mm broad neck aneurysm (3.5 mm wide) near my optic nerve behind my right eye. I’m curious if anyone here has had a clipping for a small aneurysm like this?

I have seen several neurosurgeons. First diagnosis was in June, when I was admitted to the hospital for a possible stroke. They aneurysm was an incidental finding. That neurosurgeon didn’t even come to see me, just sent his PA. Long story short, they scheduled me for a 6 month follow up (coming up in June) for another MRA and refused a consultation.

I went to another neurosurgeon and he recommended an angiogram, which I did in August. Findings were normal, but he said he thought a clipping would be reasonable (Neuro radiologist said it would be difficult to do a coil or stint due to where it’s located and since it has a broad neck). I decided to do the surgery simply to get rid of it and never have to think about it again.

I really liked that neurosurgeon but decided to get some more opinions. I went to John’s Hopkins where the neurosurgeon said she recommends surgery since I’m so young and have decades left to live. Likelihood is that at some point in my life I’d probably have to do the surgery. She said quality of life will be better since I wouldn’t have to ever worry about it again. I agreed and scheduled the surgery to happen in December.

I then went to two more doctors, both of which said they don’t recommend surgery on such a small aneurysm and they only do surgery if it’s over 4 mm. The surgeon at Hopkins said if I let it grow, there’s more likelihood I’d loose vision in my right eye and the surgery becomes more complex. She also said that other hospitals that don’t do as many of these surgeries are less willing to operate on smaller aneurysms because they don’t do as many of them.

I’m torn…I feel like the path is clear, go do the surgery, but there’s the part of me that’s really terrified of surgery and having the other doctors talk like it’s such a tiny a aneurysm, to just leave it alone and watch it. I have since changed my surgery to January to give myself the holidays and more time to think on it.

Has anyone here had a clipping for one this size? Has anyone here had neurosurgery at Hopkins?

For me…the doctors told me it was nothing and they would keep track of it, but they did not. It ruptured 5 years later. It was between my two eyes and it was clipped. This is only my experience. Many others have different experiences. If you have faith in your doctor’s recommendations, listen to that.

Thank you so much Suszanne for your comment! That’s been my exact worry…if I leave it alone and just monitor it, there’s nothing to say it won’t rupture. Thank you for sharing your story.

Hi Kmanstof, John Hopkins is one of THE BEST hospitals to be treated. I was finally treated at MGH in Boston, also one of the best, after my local hospital misdiagnosed my large, wide neck unruptured aneurysm located behind my right eye. I was lucky it did not rupture, but my 3rd & 4th optic nerves were damaged (my eye lid was unable to open & close(scary) and vision was horrid; if lid held open I saw things in quads(4 of everything) and sideways, make me nauseous, so I wore an eye patch. I was treated with Embolization Devices(also had a small one behind my left ear). My vision had slowly improved, but is still not 100%, but it looks normal to others(pupil still enlarged).
So, for me I had no choice about treatment on the big Aneurysm, but for the small near my Ear, for me there was no way i was going to “watch and see!!!”, I had that one treated as well. I wish you well on your wellness journey, please know this group is here for you.

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Thank you Starbirder for sharing your story! Wow, what a rollercoaster it sounds like you’ve gone through! I’m so glad to hear your vision is improving and you were able to treat both aneurysms! This also helps me think through my decision and decide to do the surgery even if those other doctors called it “miniscule”. Thank you, this does set me at ease.

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I had 4mm aneurysm behind my right eye. Went in for angiogram Columbia Hospital Nyc and they didnt let me leave. They did craniotomy next day. I told Drs that if i needed surgery i do not want to wait. Unfortunately they nicked my optic nerve and had to go on heavy steroids to save my eye. Which was saved but i didnt loose some vision in my eye but not bad overall. My first neuro who found aneurysm didnt seem concerned and said to wait and see what happens. I went for second opinion and they referrd me to Columbia. I do have a great aunt who died of a brain aneurysm in her 60s so that may have had something to do with it. I have to be honest that its been hell for me the last 2 years. 3 months after surgery i started with headaches. Rhey have been nonstop pain in the head. After countless drs and no one can figure out why. They said its pain in the head not headaches. So i had a neurotransmitter stimulator put in my head .it has helped alot. I went from tylenol 6x a day to maybe 1x a day. If you want any more info. Just let mw know. I dont want to overwhelm you. And yes everyone is different

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Thank you Karen for sharing your story! I’m so sorry you went through that, but I’m glad you found a solution that seems to be helping the pain!

I went to my neurosurgeon at John’s Hopkins today and shared a little bit of your story about how you ended up at Columbia and they wouldn’t let you leave/did the surgery the next day (I hope you don’t mind). She said that Hopkins and Columbia on the East coast get the largest amount of clippings each year and that other hospitals don’t perform them often, which is why they lean to the “watch and wait” approach.

After hearing everyone’s stories here and talking to my neurosurgeon again today, I’ve decided to move forward with the surgery. She pointed out to me today that I’m at the lowest risk for a thing to happen if I do it now. Who knows what the future will bring, but keeping positive thoughts out there and hoping for the best.

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My rupture was behind my right eye and was less than 5mm. I am fortunate that my vision was not affected long term. I had double vision for a short period of time. If there is any risk that this is going to grow or rupture, I would find a doctor that can take care of it.

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