I landed in the emergency room with THE worst headache I have ever had. They did a CT scan and found “a fusiform dilation of up to 4mm” on the basilar artery and that it is "unclear if the findings reflect a dysplastic or fusiform aneurysm."What does all that mean? Is 4mm serious? What size is serious?
My neurologist diagnosed me as having had a severe migraine and said to just come back in a year, that he’s not worried about the aneurysm, that it could just be an incidental finding. Does this sound logical? Just the word "aneurysm " is caring the heck out of me.
Hey msussman,
4mm is considered small in fact anything less than 7-8mm is considered small. 8-12mm is considered medium and 12-24mm is large. Anything larger than 24mm is known as a giant aneurysm. For some aneurysms they can bulge out like a balloon on one side of the vessel having a distinct balloon shape. Where the rubber balloon is knotted is considered the ‘neck’. This is known as saccular (or sac like) aneurysm.
With a fusiform aneurysm the vessel bulges on all sides. Often fusiform annies are considered to be a lesser risk as the pressure is distributed evenly over the whole surface of the artery rather than being focused in a smaller location like the saccular.
When they say ‘dysplastic’ they mean it may simply be that a natural extension of the walls of the vessel.
So in VERY layman’s terms when they say 'unclear if the findings reflect a dysplastic or fusiform aneurysm." They are really saying they are not sure if it’s a natural bulge in the vessel wall or an aneurysm. If it is a fusiform annie it’s of lesser risk than a saccular. There can be a few variables to this such as patient age, but in most cases a lesser risk.
Its the radiologist’s role to write a report on what they see on the scans, so even if it’s insignificant the radiologist MUST write it in the report. It’s the neuro’s role to interpret the report and make an assessment from there.
I can assure you ANYTHING neuro related scares the bejesus out of anybody, but from my understanding (and I am NOT a dr and have NOT seen your scans nor report) it sounds as if the information you have been provided is correct.
Neurosurgery is not undertaken lightly and often a ‘wait and watch’ approach is advised. For some conditions any progression maybe very slow so medicos monitor over a period of time to see if there is progression. If your headaches/migraines get worse then do not hesitate, get to your pcp. But otherwise follow through with your neurologists advise in a year. I think the old adage of “Be aware, not alarmed” rings true here.
Hope it helps
Merl from the Moderator Support Team.
I just want to add a bit to the mix here. One should not be too dogmatic about some issues. My wife’s aneurysm was 6mm, and our neurosurgeons told us that was large (in comparison to what?). They told us that most of what they saw was in the 1 - 2mm range. Probably depends on the kind and the location. We do know that the effects of her rupture were huge.
Thank you SO much for the information! I’ve read different things on the internet, especially about size, but you never know if the internet information is accurate. I feel so much better with a source I can trust!
I must say, I often feel (emotionally) like there is now a ticking bomb in my head. I am so claustrophobic that I couldn’t get in the MRI machine with that helmet on my face. The neurologist seems fine about it since he said it wasn’t a big deal based on the lab report and evaluation–which, frankly, doesn’t seem like much of an evaluation (reflexes, walk on your toes, questions).
I must agree with ADRauch on their statement ‘Probably depends on the kind and the location’. The location can have a HUGE impact on anything neurological, but generally “…7-8mm is considered small. 8-12mm is considered medium and 12-24mm is large. Anything larger than 24mm is known as a giant aneurysm…”
My aneurysm was 4mm and after my surgery my neurosurgeon told me thank goodness I got it clipped bc it was so thin he could see right through it and likely would have ruptured sooner than later. I do think it just depends. I did have headaches behind my eye as a symptom so maybe that makes a difference, too.
My aneurysm was 3mm when it ruptured. I had no idea it was there until it ruptured, but they did fix the other small one they found while doing the craniotomy for the ruptured one. So many different factors affect the aneurysm and its risk for rupture.
msussman any size can rupture and while it is true the odds are greater the larger the aneurysm is; however if it happens to you then it is 100% for you. It’s kind of like the lottery millions play understanding they probably won’t win and your odds of winning with one ticket is less that if you have 100 tickets. And yet someone wins, in case of the lottery generally a welcome event; with an aneurysm not so much.
Hi My name is Beata, in 2012 my aneurysm if 2 mm ruptured and nearly died, so I had a coil done on the one that is left and it is a 5mm, I would now get a second opionion and do not go up in an airplane or have adjustments to your neckk by a chiropractor.
Makes sense. If the doctor’s not worried I’m not sure whether to leave it at that or get another opinion. Thoughts? In NYC you could die before you can get an appointment with a neurologist in a reasonable amount of time… I asked my pcp about that and she said that, sadly, people often end up in the emergency room. The only way I even got an appointment was because she had a colleague in the hospital network.
My aneurysm was found after it ruptured (and I experienced a hemmorrhagic stroke). Apparently, I clot decently well, and mine closed up and refilled once my blood pressure dropped. By the time I was found, transported, examined, clipped, and stapled closed, the doctors told my family it was a single SILENT 22.5mm aneurysm that had ruptured.
I have not had one since, but the worry is always there that I will experience another - and that any size aneurysm is potentially fatal.
I’ve not gotten through all of it yet but there’s a good section on aneurysm size and rupture. Mine was 5mm when it ruptured.
Merl gave an excellent description on a dysplastic or fusiform aneurysm. Here’s a pretty recent study,https://thejns.org/downloadpdf/journals/neurosurg-focus/42/6/article-pE14.pdf
you will have to do searching on your own, but stick to the journals and sites like NIH, JNS, the Europeans have a good amount of studies as well
Beata, I fly at least once a year. Last year flew from NC to WA I have had no issues with flying. Ruputured 2013, coiled x3. I am curious as to why you think someone should not fly?
I have 11.8mm coiled and 3.8mm uncoiled aneurysms and fly frequently. Neurosurgeon advised flying was perfectly ok. Why would you think it’s not okay to fly?
I was wondering about flying because one of the earlier posts mentioned not to fly, which I’ve done several times and felt fine, but feeling fine now doesn’t mean feeling fine five minutes from now.
Hi moltroub
Thank you for the very informative 2016 article. I have a 5mm unruptured saccular aneurysm and it scares me to walk around with it in my head every day. I didn’t realise alcohol was a risk factor as my doctors have always told me it isn’t.
Please post any other articles that you hear about. I prefer to know facts and statistics about risk factors so I can hopefully do whatever I can to stop mine from rupturing although I know sometimes there’s nothing at all you can do. Thanks again.
Hi,I was diagnosed with an 15 mm Fusiform aneurysm of the cavernous segment right carotid artery in Oct 2017 and at first I PANICKED as all I knew about aneurysms was you keel over unexpected and die ,but to my relief my consultant said no worries,come back in year and we’ll check again ,beginning of February 2019 I was told ,it’s in a perfect position and is not likely ever to rupture as I’ve probably had it for years and years as the bone has fused around it and finialy told me go get on with life and no need for any more scans unless my eyes start bulging and giving me pain and that might be a sign that some pressure has built up .so plenty of time to be sorted .but this so rare no need to worry .
So please don’t waste your energy in worrying as stress is more damaging ,get the information from your consultant and don’t take unnecessary risks with unnecessary procedures.- good luck and I wish you a long and healthy life.
Thank you, I like studies as well. My Neurosurgeon said I can have a glass daily. At my wedding, I told them not to let my glass go empty, thus it was one glass
msussman, I ruptured. The doctors told my partner not to expect much if I woke up. I just remember them saying “there’s too much blood”. I live my life the way I want to. It’s all about quality, not concerned about quantity.
