Hello, friends. I saw my neurosurgeon today and am considering the clipping operation for my 7+mm wide neck aneurysm in the ophthalmic region. Would like to hear experiences of those who have chosen clipping to repair a similarly placed aneurysm. Thank you.
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I had aneurysm clipping now ten years ago for a wide necked 7mm carotid-ophthalmic aneurysm. We went back and forth on the approach but decided to do surgical instead of stenting because of the wide neck and because I was 24 years old (data is limited but we all felt clip would be the way to go). I had a complication of chemical meningitis - irritation and swelling which kept me in the ICU for a few days. But otherwise walked out of the hospital in a few days. I was on keppra for a few days but that was it. After that it was healing from the headaches and just overall lethargy. Was tough sleeping on the right side so just avoided that until things healed up some more. Took things slow and got better. Ten years in, I feel fine. There is some muscle atrophy on the side (Temporalis muscle) but nothing significant.
Clipping is certainly more invasive than stenting. Both have their pros and cons and you should discuss that thoroughly with your surgeon. Sometimes it just comes down to the dimension of the wide neck - only clipping may be an option.
I do have a “pterional craniotomy” scar. But the hair covers it. Everytime I get a hair cut that’s a bit short the scar shows, but I don’t mind it. The scalp in that area still feels weird. I can also feel the screws/plates used to secure the bone flap. Occasionally if the dog paws my head and it hits it at the wrong angle then it hurts. I still do get headaches and I call them my “titanium headaches” and think maybe it’s the titanium in my head that’s going off. But Tylenol usually helps. Once it was very bad and I went to the ER to make sure there wasn’t an aneurysm issue.
Overall got very lucky. After the surgery my surgeon said that given how things looked the aneurysm may have ruptured in a few months! My lifestyle now is normal. I don’t bungee jump or sky dive or go on roller coasters. I’m careful if I am in concerts or crowds where people’s elbows could potentially hit my head / bone flap. But I don’t think I have any limits when it comes to exercising and being adventurous. I run, bike, swim etc…
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Thank you so much for this detailed response. I am still weighing two options. I like the one and done feature of the clipping, if it truly is one and done, but concerned about possible damage to my optic nerve, among other risks. Again, thank you.
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Hello there,
Sorry to hear you’ve got an unruptured, but always better to find out that way! I had a 3-4mm unruptured clipped on the ophthalmic segment of my ICA about 10 months ago.
My understanding is it’s a challenging place to operate; I was told there was a 1% chance of things going badly and 2% chance of some blindness (be it temporary or permanent).
That said, 10 months out of surgery I have had plenty of niggles post operation, but no substantial or serious problems. The surgery was a success and from my perspective it was totally unviable to carry on facing every day knowing that a rupture was a possibility.
I don’t regret having the surgery at all; it’s a very stressful time and I am told you’re in for about 3 months or intense recovery and about 12 all up to be fully back, but 10 months out I’m back to full time work and running 3-5 times a week. That said, I wouldn’t change my decision to have the surgery at all.
Please reach out to me if you’d like any more information 
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Thank you! Glad to hear your clipping was a success! Did you have a big scar? Indentation? I am still weighing clipping or endovascular. Will get a third opinion from doctor who does both. Again, thank you!
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Hello,
I had my “Annie” successfully clipped in Nov 2014. My aneurysm is located on the right in the Circle of Wills. The surgery took about eight and a half hours. I spent three days in ICU and a few more days at the hospital before going home. As predicted it took about twelve weeks of PT and rest to recover before returning to work. I was able to work until I was old enough to retire three years ago.
I experience some minor deficits but overall lead a very happy life. I rarely have headaches so don’t worry like I did before surgery. I have a scar in the hairline of my right temple. I no longer have the ability to perspire but current neurologist says he can’t find a case study to show this is connected. Although the condition only started after the surgery. I do have minor trouble with my quads being strong enough to lift myself out of a chair without using my hands but once up or down no problems. I walk for exercise most days.
I wish you the best, I am glad I chose the clip.
Take care!
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Thank you for sharing your experience. I’m still deliberating and will get a third opinion, but I do like the “one and done” aspect of clipping. I hope you continue to do well!
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Keep in mind that it’s not truly one and done. Even with clipping there are risks of recurrent aneurysm formation at the site down the line. And with coiling there are risks of coil migration and aneurysm growth. No procedure is without risks so definitely weigh those accordingly with the doctors. Don’t mean to scare you but best to be informed of everything. Also about your concern of the optic nerve. I had the same concern. Mine was touching the optic nerve so they had to do various maneuvers to mobilize the area to get good access and not injure the nerve. There was a risk I could have a blind spot but it was very minimal and I ended up with no vision issues at all
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Thanks again. I am seeing another doctor who does both surgery and endovascular repair to consult about which might be the best option for me. I appreciate your detailed response. I indeed expect that none of these procedures comes without risk or multiple follow-ups.
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Thanks for the info Curious 1. I have ~4mm annie in the same place, and am doing watch & wait right now. Was thinking stent, but now will consider clipping.
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Hello! Sorry I missed this!
I have a scar in the sense that I know it’s there, but no one notices it. Like I have to tell people it’s a scar and not just a line on my forehead. I did have a fantastic surgeon though.
I also have a small scar on my neck which is more noticeable, but in a less obvious place. Without wanting to gross you out, basically I am told one of the big issues with operating on an aneurysm there is access. So if it ruptures during surgery apparently there’s not many places the surgeon can redirect the blood while they fix the rupture, so in my instance the surgeon made a small incision in my neck before going near the aneurysm, so that if it ruptured during surgery he could try to redirect the blood out there while he fixed it. Thankfully there was no rupture during surgery.
I noticed your comment about it being one and done, and I take a lot of strength from this video I found:
If you listen around 3:20 there’s some good opinions on clipping effectiveness. It’s also a really good video overall that shows you’re going to feel rubbish for a while.
Hope this helps and please feel free to ask me more questions if you like
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Thanks again. I have listened to the video twice now. Very helpful. And thanks, too, for saying more about your experiences.
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I have 4 unruptured brain aneurysms with the largest being around 3.5 mm discovered 18 months ago when I had a mild stroke. I am interested in knowing more about your surgeon as well as where you reside . Presently I am on wait and watch program with a yearly update MRA scan next week . I already had an angiogram last October to determine the size and location of each.
I also would like a second opinion on procedures and outstanding surgeons that walk you through the types of procedures.
Thank you.
Maryanne
Good morning Maryanne! If you’re wanting a specific member to respond, you can do it one of two ways, click on reply to their post, or use the @ and follow it up with the name they’re using (actually a list of members who responded will pop up and you can just click on that).
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Thank you
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My aneurysm, which ruptured, was clipped. I really had no choice in the matter because I was unconscious when the decision was made. That being said, I am very glad it was clipped. Recovering from a craniotomy takes a while but overall I think it was worthwhile. Three years later my clip is still in place and I don’t worry about it.
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Thank you for sharing your experience. I chose an endovascular stent as the solution. No problems after the procedure. So far everything is going well. Best wishes for continued health and success.
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@Mabh212 If you are willing to drive a couple hours down to Washington, DC for a second opinion, my neurosurgeon was outstanding IMO: Rocco Anthony Armonda, MD| Neurosurgery | MedStar Health. You can even watch this YouTube podcast (he was a warzone doc - or Google him) to get a sense of his personality/approach Episode 01- Rocco Armonda
You can click through my profile and stories to get more of my background and experience with him to some degree. In my experience, if you had an angiogram in October, he would want to wait at least three months before another angio, and probably preferably would want to get the images from your October angiogram(?).
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Dr Armonda was on my procedure team. He offered a third opinion which led me to choose endovascular treatment over a craniotomy. My case allowed me to have that option. My chief doctor was Dr Stemer , interventional radiologist, at Medstar Georgetown University Hospital. Both doctors and all the staff at Georgetown were excellent. Very happy with my treatment
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Small world! Yes, Dr. A is at both Georgetown University Hospital and Washington Hospital Center. When I first ruptured, I ended up being airlifted to WHC from Sibley ER. I actually have a tentative appt with Dr Stemer on the Neurology end of things… complex story, so I may meet him soon!
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