My 74yo mom with unruptured giant and growing 26mm ICA cavernous aneurysm with symtoms affecting vision is counting on me for supporting her in decision to choose btwn surgeons and tx interventions. I’ve been reading through posts re after surgery symptoms and offering guidance for her and my dad’s questions but I suddenly feel ill-equipped to offer my opinion. It’s overwhelming and I’m caught btwn grief and responsibility but decision needs to be made this week. The options are a Mayo Clinic neurovascular ICA sacrifice if she passes the balloon test occlusion during angiogram but I worry about permanently blocking carotid like that. And the other neurosurgeon at OU Health is comfortable doing angiogram through wrist as indicated by our familial connective tissue disorder and wants to treat with flow diversion with what I assume is a stent. My mom is allergic to some metals too so we’re waiting on that test as well. I’m just throwing all this out here in hopes that we feel more confident going one way versus the other. My grandmother and one aunt suddenly died of cerebral aneurysms; another aunt and uncle passed with complications; and multiple 1st cousins (many of their combined children) are currently experiencing vascular dissection, aneurysm, and heart valve issues. All of this to say that I am terrified and really having difficulty, calmly navigating this situation all while raising kiddos, working and flying cross country to assist in my mom’s (and dad’s stage 4 bone cancer) treatment. Thanks for listening because I almost feel better just getting this story out of my head…
May God be with you and your family during this difficult time. These type of decisions are very difficult to make. I had my “Annie” clipped by Dr Ramos in Little Rock, Arkansas ten years ago. I’m not sure what resources are available to you. Continue to ask questions and seek as much information as you can. Take care!
Welcome JD, My, you do have a load on your shoulders right now! This is really a “bless your heart” in the good way down here in the South. You and your family have a lot to deal with between bone cancer, the vEDS (had to look it up) and the familial aneurysms. Makes me wonder if there’s a link between the two, at least with your family…
I remember having to help my parents decide their health choices, it isn’t easy but it helped me to know what they wanted and I just stuck to their plans with the medical teams. I had already ruptured so it made me like a dog with a bone and I was set on them getting what they wanted. Hopefully you and your parents have spoken about it. As we age, we change our minds about our future it seems.
You are correct, a flow diversion is a stent, which one would be up to the surgeon, there are several. My arteries are tortuous (squiggly) and my Neurosurgeon usually went through the groin until my last angiogram to check on my stent placement six months earlier and she was able to go through the radial artery. They checked it with an ultrasound first and the Resident hit a roadblock with a 90 degree turn so Dr. Q-W did the turn and got it to my brain.
I presume your Mom also has vEDS, have either of the two surgeons discussed it with her specialist? Because vEDS is rare, I wonder if either are familiar with it and what to expect. That would be my first question to both and I’d probably go with the one that’s familiar with it or has at least consulted with a vascular surgeon who is knowledgeable. I’m not a big fan of doctors who think they know everything, I am a big fan of doctors who take the extra time to learn and who are confident in their abilities.
Remember we are here for you. I’m sure others will come offer their support. Remember to breathe and remind your Mom she has to stay hydrated before and after the procedure.
Welcome @Darkstar!
I am so happy you found us, and that you were able to voice all you are going through, especially to others who have been in your shoes. I am the patient, not the caregiver, but I have seen how hard it can be on them, so please find some time for you in all of this - it is **vital **you take care of yourself as well!
@Moltroub knows me well enough, and knows that I am going to echo her on the importance of breathing techniques. My particularly favorite method is called box breathing as it has 4 stages like the side of a 2D box. Step 1: breathe in for a count of 5. Step 2: hold for a count of 5. Step 3: exhale for a count of 5. Step 4: exhale for a count of 5. Repeat as necessary! I love that it is so easy I actualy remember it, and -of course- I find it effective to calm down a little when things get nuts!
Post-rupture, I was advised to take up meditating, and I am finding it super helpful in helping to manage things like stress and anxiety. Just the other day I heard that meditating doesn’t take time, it makes time, and I have found that to be true!
I hope also that with your family history, you are speaking with your own doctors about being screened for aneurysms too, since they do seem to believe there is a genetic link.
Finally, please remember to give yourself some grace. You are doing an AWESOME job juggling everything on your plate! Whatever choice your Mom makes will be an excellent one, as she has great doctors and a support system behind her!!
Keeping you all in my thoughts and prayers. Please let us know how it all goes!
Fin Whale Fan 
I found this video that talks about flow diversion stents Flow diversion for cerebral aneurysms in: Neurosurgical Focus: Video Volume 7 Issue 2 (2022) Journals and here is on specific to the cavernous ICA Challenging access during flow diversion treatment of a giant cavernous ICA aneurysm in: Neurosurgical Focus: Video Volume 7 Issue 2 (2022) Journals
Realizing it doesn’t help you to help your Mom make a decision they do show how it’s done.
Thank you so much. Just confirmed she IS allergic to titanium so…processing what that means. Meanwhile it’s just growing and at 26mm now 
That sucks! I have mostly platinum in my brain, my stent is made from Nitinol, so unsure if they could use that. But I found this https://youtu.be/OA5VK7b1Lmw?si=sMz__byUjBD1c7ef which gives hope. There’s also stainless steel that I just saw on AI for a search on what other metals can be used. Can she have any of those? Found this https://www.ulbrich.com/blog/special-metals-make-unparalleled-medical-devices-possible/ and this Metals and Minerals in Medical Implants | U.S. Geological Survey
Much appreciated! I am all searched out and down for the count mentally rn.
I also had a Gigantic aneurysm. Mine was treated with a pipeline which is a mesh stent that allows blood to flow in and out of the aneurysm so that it slowly clots and then the body absorbs the clot. This was done by a neurosurgeon inserted thru the groin. This was done in 2018 and I have not had any bad side effects. My last cscan shows that the aneurysm has shrunk and is now turning into mush as the body absorbs what is left.
I hope that this helps with your decision and I pray good health for your Mom.