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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.
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@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.