Brain angiogram shows infundibular, outpouching. Concerned about risk

Posted by hendglenn2000 @hendglenn2000, Dec 30, 2021

COMPARISON: Prior CT angiogram of the brain 7/2/2018. Prior MR angiogram brain 6/22/2018.

FINDINGS: Current exam once again demonstrates a 2 mm outpouching along the basilar artery termination extending slightly to the left of midline. There is evidence for is tiny vessels arising from the apex of this outpouching could represent small perforating vessels or tiny hypoplastic P1 segments. The configuration is similar to previous exams. Findings favor infundibular configuration rather than an aneurysm

There is mild narrowing of the mid right intradural vertebral artery was not definitively seen on previous CTA exam. This area was not included in the coverage field of the prior MRA exam. Findings may be artifactual secondary in plane saturation effects. No other definite significant stenosis of the intradural right left vertebral arteries or basilar artery seen.. The right and left posterior cerebral arteries are supplied primarily through the posterior communicating arteries consistent with a functional fetal origins. This is unchanged from prior.

The intracranial right and left internal carotid arteries as well as the proximal right and left anterior middle cerebral arteries appear grossly patent but significant stenoses or large branch occlusions. No gross aneurysms of anterior circulation vessels are apparent.

Axial T2-weighted images once again demonstrates postoperative changes of a right temporal lobectomy unchanged from previous. There is evidence for small chronic right hypothalamic lacunar infarct also unchanged from prior. Minimal partial opacification of left ethmoid.

This report has me very concerned since I lost my entire family to heart disease and stroke. I'm 60 and already had a stroke 5 years ago and wondering what action if any I should be pursuing?

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feelingthankful | @feelingthankful | Jan 10, 2022

Hi,

1)What is you neurologist and/or neuro surgeon (if you need one or can ask saying?) If no symptoms I believe they possibly may tell you “infundibular“ things are significantly less of a risk than aneurism and 2mm is small and they may just consider watching it or not even be worried about it, but am totally guessing without knowing. Ask them.

2)was you right thalmic stroke symptomatic and if so what symptoms,. Was it a lacunar stroke from high BP or something else. If yes you need to manage risk factors.

3)what is this speaking to “ Axial T2-weighted images once again demonstrates postoperative
changes of a right temporal lobectomy unchanged from previous. ”

My questions and guesses for suggestions would e be:

1)maske sure your doctor is communicating with you or find another one and write down all your questions before your visit or email them on the portal. Sometimes in this area they don’t clearly know and each MRI changes what they say.

2)if you still have questions get a second opinion or ask them until answered. Write down their answers. …., if you do ever want a second opinion consider mayo or well rated docto/place if possible.

3)make sure you are following and managing all lifestyle recommendations for stroke and things and doctors may have given you after you had one (guessing like all patents risk factors include possible diet, exercise , weight and blood pressure, possibly meds). Possibly confirming no blood sugar issues is a big one or managing. Your doctor will know the risk factors if any to test or instruct.

Good luck.

Ps check out dean ornish on YouTube for cardiac stuff if you find interesting and helpful for cardiac things.

Good luck.

hendglenn2000 | @hendglenn2000 | Jan 10, 2022

In reply to @feelingthankful "Hi, 1)What is you neurologist and/or neuro surgeon (if you need one or can ask saying?)..." + (show)

lacunar stroke from high BP, I'm under a cardiologist's care and he's watching everything. He seems to think MRA findings are ok for now. Already on many meds which keeps BP at or close to good numbers averaging 120 over 80. A1C being monitored and sugar levels are below 7.

Mshutch | @mshutch | Oct 7, 2022

When you last saw a neurologist or neurosurgeon did they suggest how frequent you should have MRA's? I was getting MRA's every 5 years due to 3 generations of cerebral aneurysms but more importantly an immediate family member. After 20 years on my last MRA they found an aneurysm and an infundibulum. I met with a neurosurgeon and had a cerebral angiogram. He told me that he was less concerned about the infundibulum and my own research seems to say that it is pretty rare for this to rupture.
I have now had surgery to clip an unruptured aneurysm and will need annual CTA's to monitor three areas of weakening that were found on the cerebral angiogram.
I am so grateful that the aneurysm was caught with the 5 year MRA but even more so grateful and very blessed to have been in the hands of the best neurovascular surgeon in the world, Dr. Giuseppe Lanzino, at Mayo Clinic in Rochester, MN.
It is really important to keep your blood pressure in a normal range but I would also check with your neurology team for how often you need testing.