Unruptured Brain Aneurysm

Hi @lisalucier No I haven’t spoken with him yet. How am I feeling emotionally through all of this…It was complete shock when I found out about them. They found two and I had a surgery for those. I woke up to find out that they found four more. Then the second surgery, the craniotomy was done eight weeks ago. He said he could get three, possibly four then. But he only got one bc of where they were located. So now I’m facing this third surgery. He said he should be able to get the last three. But I’m not having much hope of that since it didn’t work out to get the amount he said in the first two. But I’d rather him be cautious than playing all Nilly Willy up in my head.
My emotions have been crazy. So nervous before surgery and then instead of healing and it be treated and I move on, I always remember that I’m healing only to have it done again and again. I’m depressed a lot. My doctor says it’s very uncommon for someone to have six. And I’m worried that this will be the thing that takes me out. Multiple, treated and yet to be treated. The chance of them leaking, rupturing, etc, my chance is times six. Also dealing with the issues I’ve stated having post op.
For this one, he plans to go in through a catheter into the right side of my brain and treat those. Then back out to around heart level and go into the left side to try and get that one. I’m scared once again. Working in both sides of my brain at once doesn’t sound too good. Sorry for the book. I’ll stop now 😊 And thank you for asking!

@tainan: Yes, so true about one's blood pressure. My neurosurgeon told me (after my initial consult when I left him hanging about my decision to watch-and-wait or to coil) I was told to keep my blood pressure under 130 (top number-systolic) and to not do activities to cause my head to be upside down.

@lisa930. That is a lot on your plate. I'm so sorry. As I mentioned to you before, I also had a craniotomy, exactly 2 years ago today. (But for a meningioma 1/16th on an inch from my optic nerve. Two doctors told me it was inoperable but my rock star neurosurgeon at UCSF removed it successfully.) At my 3 month MRI check up post surgery I was informed I also had an almost six mm. aneurysm. I couldn't deal with another procedure so soon so delayed doing anything about it for almost a year. The new neurosurgeon (at UCSF one specializes in meningiomas and another in aneurysms) said the location of my aneurysm was not easy to get to so he suggested coiling. I am writing to tell you I had the cerebral angiogram that you referenced, where they threaded a catheter over the top of my heart (I think over the top) to coil the aneurysm that was on the left side of my brain. At UCSF they try thread the catheter through your wrist if you have easy to get to arteries. (Something like that.) At any rate, I didn't have to go through my groin. All in all, it was a pretty simple procedure. I wouldn't be afraid of it (like I was-stressed out for a year until I had it done) I only spent one night in the hospital. If I remember correctly, I think the total time for the procedure was about 3 1/2 hours. I was angry and depressed, as you are, after learning that I had yet another surgical procedure to go through. Another bump in the road we call life but you got this. You're going to come out on the other side and be glad it's over with.

I would love to know who your doctor was at UCSF? I was recently diagnosed with an 3.7 aneurysm in my basilar artery. I did have an acoustic neuroma 31 years ago that I never fully recovered from because my doctor accidentally nicked my brain stem upon removal. I see my local neurologist Wednesday (although not a neurosurgeon) but know first hand that a good neurosurgeon can make the difference. I’m trilled your experience turned out favorable.
Thank you for any information you can provide. I live in Portland Oregon so travel to UCSF is absolutely doable.

@sugarbaby : Happy to share. The neurosurgeon at UCSF is Dr. Winkler. You can have your scan sent digitally to UCSF. (Hopefully the clinic where you had it done has the information of how to easily transfer scans digitally.) My first visit with Dr. Winkler was a ZOOM visit. He'll put your scan on your computer screen and go over the particulars and make a recommendation. And you wouldn't have to fly in for a pre-procedure visit. The anesthesia dept. orders blood work and spends 45 minutes on the phone with you taking your health history. I was also surprised (but shouldn't have been, I guess) that they seemed to have records of all my doctor visits at the Sutter health organization, which is not affiliated with UCSF, and the meds I take. Sharon is the person who schedules for him and to eventually get to her dial 415-353-7500. Also, when I first found out I had an aneurysm, and was majorly stressing out, I found a video on-line by a neurosurgeon at the the Univ. of Penn. It is a 35 minute video that was so informative it calmed my stress and anxiety until I could schedule with Dr. Winkler. Just type in the google search bar, "Dr. Omar Chouddhri University of Penn. aneurysm video." He brought up the fact that many patients who are referred to him for an aneurysm actually have something else called infundibulum, which is mistaken for an aneurysm. Anyway, great video about aneurysms if you're interested.

@mkoch Thank you so much for responding. I’m going to check out the YouTube video. I know Penn is one of the best hospitals in the country. I’m going to check them all out because I believe I have time since it’s relatively small. I’m so thankful to you and to have the additional information to talk about on Wednesday. I’m a little extra paranoid because when I had the acoustic neuroma I woke up with paralysis on my left side. Everything fell apart after that and have been on disability since I was 33 (31 years ago.)
I’m really concentrating on getting things right this time.
Many, many thanks to you!
God Bless-
Lori

Had an incidental finding of a a 4 mm superiorly directed aneurysm of the left paraclinoid ICA in March 2025 during an MRI, which the pain doctor was looking at the nerves, do to unsuccessful, jaw surgery. After the finding, I was sent to get a MRA, which pointed out that the aneurysm is 5.4 mm, not 4 mm. Was referred to a neurosurgeon and a phone call appointment was set, never met him in person. He called me, had a 5 minute phone call, which started with "do not Google your aneurysm", and dismissed every question I asked, he kept saying "not going to happen, don't worry about it". I noticed that his after visit notes did not reflect what we spoke about during our 5 minute call. He mentioned a page and a half of things we did not spoke about and/or he dismissed. I reached out to him, via email and pointed out his inaccurate notes, he called me back within a few of hours of me sending the email, to apologize and ask for a second chance to explain my aneurysm. I felt no confidence in him and got a second opinion. Second opinion is from an out of network neurosurgeon, which I had to pay out of pocket for the visit. I found out that the 2nd opinion neurosurgeon, also happened to be 1st opinion doctor's teacher/mentor (i was not aware of this). The 2nd opinion neurosurgeon, is offering a stent, since I am young healthy and pointed out the risks of doing this procedure. He also suggested surveillance, however, he said he couldn't predict how the aneurysm was going to behave if we just do surveillance. I am scared and don't know how to proceed.

@srodriguez25: Please read my prior post on this thread and watch the video by Dr. Omar Chouddhri at the Univ. of Penn. Sometimes I wonder if he made that 35 minute video for people whose neurosurgeons don't offer a lot of information and shut down questions. I had a 5.5 aneurysm coiled 10 months ago at the Univ. of Calif. in San Francisco. At my 6 month post-procedure video visit (after learning everything looked good and asking a few follow-up visits) I said, "Ok. Thank you for your time. I know you're very busy so I'll let you go." Dr. Winkler's response ( a neurosurgeon who specializes in aneurysms) said, "No, no. That's what I'm here for. After we hang up if you remember something you forgot to ask call Sharon (his scheduler) and I'll get back to you." Given that back story I'll offer my opinion on what I would tell my sister should she be in your situation. First of all, your in-network doctor was a jerk. But he did ask for a second chance. It is encouraging that you found out that the neuro doc you saw for a second opinion was your in-network doctor's mentor. Probably "Doctor Jerk" is well trained and would feel a sense of doing his best knowing that you had consulted with his mentor. Secondly, after you watch the video by Dr. Chouddhri I think you'll be convinced that active surveillance (also called watch-and-wait) should not be a choice for you. Yours is not a miniscule aneurysm. The rule of thumb is about 5mm or more should be seriously considered for an intervention whether it be coiling, stenting, or clipping. I would suggest you go with the 2nd neurosurgeon but he's out of network and my coiling procedure was over $50,000 so do you really want to take that kind of debt on.

@smilton, I agree with your advise above. Adding one more: No smoking (even second-hand smoke exposure) vàping. Monitor blood pressure (with a wrist BP cuff or Apple health wristwatch), and yes, smile and ðon't let anyone or anything get inside your head and ness/stress you up. Safe travels, safe procedure, and smooth recovery!