Infundibulum in my brain: What are treatment options?

Posted by kimbo @kimbo, Aug 31, 2017

Diagnosed with 2 mm Anterior Communicating Artery Infundibulum. Any advice is appreciated.

@sam89

I had an episode of syncope on 01/29/2019 where I lost vision and blacked out for approximately 45 minutes. I had had a mild migraine that day and then a awful migraine that has lasted off and on since then (almost a month). I'm on a medication to manage the migraines and have gone about 4 days without migraine since the syncope episode. During the two weeks after the syncope episode, particularly about 1 week after, I started to notice issues with my memory since the episode on the 29th. I completed a brain MRI without contrast on 01/31/19 where a brain malformation was identified on 02/04 MRI with contrast, ended up being a capillary entanglesia (brain birth mark) in my right lateral pons. Contrast MRI also revealed what appeared to be a small 2mm ICA Right Subchoid aneurysm. My primary care physican told me it was nothing to worry about and contemplated referring me to neurology. Around 02/09 I began having more significant issues with memory, difficulty speaking and complete facial numbness. I was evaluated at the hospital and they noted weakness on both sides of my body, more predominantly on my left. They gave me an injection of medication for complex/hemipleagic migraine. This made the majority of symptoms greatly reduced after approximately 45 minutes. However, intense pressure (felt like a balloon) remained behind my right eye. Spoke with neurosurgeon on 02/19 (finally) and he is going to have me complete an angiogram because he is concerned that it could be an infundibulum, not an ICA aneurysm.

Additional information/family history: My 3.5 year old daughter has a brain malformation (unknown), they previously thought it was an AVM. However, they are thinking it could be a CVM. Within 24 hours of birth she presented with seizures. MRI revealed that she had a stroke. They have completed several MRI's since then and are now doing them annually (she will have another one in April when she is 4) but the area has shown up unclear on past MRIs for them to make an official determination of the type of malformation that she has that caused her to have a stroke.

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Hi, @sam89 – welcome to Mayo Clinic Connect. I'm sorry to hear about your dear daughter, and also about all these symptoms you've been experiencing, with losing vision, blacking out, migraines, syncope episode, memory issues, difficulty speaking and facial numbness.

Since your neurosurgeon is now wondering about whether this is an internal carotid artery (ICA) aneurysm or an infundibulum, it's good that you will be having the angiogram and get some clarity.

Hoping that @smartmove2 @kariulrich @angie4 @kimbo @hopeful33250 will return and offer their support and insights as you seek to define clearly if you have an infundibulum.

How are your symptoms today? Which symptom is causing you the most trouble?

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I had a sudden onset of headaches and pressure around my left eye. I brought this up at an already scheduled annual exam. My doctor recommended I have an MRI/MRA. The findings were: Head MRA: 4 mm left internal carotid artery ophthalmic segment
saccular aneurysm. Brain MRI: Normal.

From this, I met with the neurology department and completed a CT with dye. Their findings were: Redundant left ophthalmic artery infundibular origin versus small aneurysm. Catheter angiography would be helpful for more definitive characterization.

I am planning on having my Angiogram on Friday to hopefully help determine whether this is an aneurysm or not. In the mean time, I also just found out that my sister had an MRA and her findings were that she has either a small aneurysm or infundibulum nearest the carotid artery.

My questions are: can an infundibulum lead to an aneurysm and are infundibula genetic or hereditary?

Thanks in advance!

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@angie4

I am completely lost. During the most abnormal migraine of my life 3 weeks ago, I was given an mri. An infibulum was found. My migraine continues on and off for 21 days now. I have strange neurological symptoms like numbness on one side and terrible cognitive issues like never before, yet my Neurologist insists I don't need to be seen again for 6 months and the symptoms are all due to a regular migraine – completely unrelated to the infibulum. I have family history of stroke and aneurysm. This is not a "normal" migraine for me. Am I being an alarmist or is a second opinion warranted here? I just feel so defeated after 2 er visits and 2 Neuro appts.. they just say its all normal. It will go away. In the meantime, ive lost 3 weeks of my life.

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Asking for your medical reports and cd is very smart to do. You can read the radiology reports and decide if you need to find a new doctor or speak to a new specialist to assure you of the findings

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@kmaureenc21

I had a sudden onset of headaches and pressure around my left eye. I brought this up at an already scheduled annual exam. My doctor recommended I have an MRI/MRA. The findings were: Head MRA: 4 mm left internal carotid artery ophthalmic segment
saccular aneurysm. Brain MRI: Normal.

From this, I met with the neurology department and completed a CT with dye. Their findings were: Redundant left ophthalmic artery infundibular origin versus small aneurysm. Catheter angiography would be helpful for more definitive characterization.

I am planning on having my Angiogram on Friday to hopefully help determine whether this is an aneurysm or not. In the mean time, I also just found out that my sister had an MRA and her findings were that she has either a small aneurysm or infundibulum nearest the carotid artery.

My questions are: can an infundibulum lead to an aneurysm and are infundibula genetic or hereditary?

Thanks in advance!

Jump to this post

Hi, @kmaureenc21 – how did things go with your angiogram? How have your headaches been lately?

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@kmaureenc21

I had a sudden onset of headaches and pressure around my left eye. I brought this up at an already scheduled annual exam. My doctor recommended I have an MRI/MRA. The findings were: Head MRA: 4 mm left internal carotid artery ophthalmic segment
saccular aneurysm. Brain MRI: Normal.

From this, I met with the neurology department and completed a CT with dye. Their findings were: Redundant left ophthalmic artery infundibular origin versus small aneurysm. Catheter angiography would be helpful for more definitive characterization.

I am planning on having my Angiogram on Friday to hopefully help determine whether this is an aneurysm or not. In the mean time, I also just found out that my sister had an MRA and her findings were that she has either a small aneurysm or infundibulum nearest the carotid artery.

My questions are: can an infundibulum lead to an aneurysm and are infundibula genetic or hereditary?

Thanks in advance!

Jump to this post

Hello @kmaureenc21,

As it has been a while since you last posted about seeing a doctor regarding a possible aneurysm, I was thinking about you and wondering about the outcome of that appointment.
What type of treatment was suggested? I hope you are feeling better now.

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@sam89

I had an episode of syncope on 01/29/2019 where I lost vision and blacked out for approximately 45 minutes. I had had a mild migraine that day and then a awful migraine that has lasted off and on since then (almost a month). I'm on a medication to manage the migraines and have gone about 4 days without migraine since the syncope episode. During the two weeks after the syncope episode, particularly about 1 week after, I started to notice issues with my memory since the episode on the 29th. I completed a brain MRI without contrast on 01/31/19 where a brain malformation was identified on 02/04 MRI with contrast, ended up being a capillary entanglesia (brain birth mark) in my right lateral pons. Contrast MRI also revealed what appeared to be a small 2mm ICA Right Subchoid aneurysm. My primary care physican told me it was nothing to worry about and contemplated referring me to neurology. Around 02/09 I began having more significant issues with memory, difficulty speaking and complete facial numbness. I was evaluated at the hospital and they noted weakness on both sides of my body, more predominantly on my left. They gave me an injection of medication for complex/hemipleagic migraine. This made the majority of symptoms greatly reduced after approximately 45 minutes. However, intense pressure (felt like a balloon) remained behind my right eye. Spoke with neurosurgeon on 02/19 (finally) and he is going to have me complete an angiogram because he is concerned that it could be an infundibulum, not an ICA aneurysm.

Additional information/family history: My 3.5 year old daughter has a brain malformation (unknown), they previously thought it was an AVM. However, they are thinking it could be a CVM. Within 24 hours of birth she presented with seizures. MRI revealed that she had a stroke. They have completed several MRI's since then and are now doing them annually (she will have another one in April when she is 4) but the area has shown up unclear on past MRIs for them to make an official determination of the type of malformation that she has that caused her to have a stroke.

Jump to this post

Hello @sam89,

Last year you posted about health concerns for both you and your daughter. How are you doing? Have you had any treatments that have helped the symptoms you were experiencing?

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Hello I'm new to this blog and was just diagnosed with a 8mm aneurysm left intracranial artery, I was referred by my vasuclar surgeon to see a neurologist but could not get an appointment due to the holiday so I have to call back tomorrow. It all started with a lump on my left carotid artery and my ppo sent me to a vascular surgeon who ordered a ct scan of my neck and a cta of my brain. The lump showed a 3.3 cm ectasia of the aortic root. I have no idea what any of this means. I did some research and because of my age, 72 and family history by brother also has an aneurysm. I seem to be a candidate for a procedure known as coiling. I also took a fall three years ago and hit my left temple on my night stand and passed out was taken to the ER. They did a CT scan but it did not show anything then. I'm so scared I feel like a walking time bomb!!

REPLY
@bluerose72

Hello I'm new to this blog and was just diagnosed with a 8mm aneurysm left intracranial artery, I was referred by my vasuclar surgeon to see a neurologist but could not get an appointment due to the holiday so I have to call back tomorrow. It all started with a lump on my left carotid artery and my ppo sent me to a vascular surgeon who ordered a ct scan of my neck and a cta of my brain. The lump showed a 3.3 cm ectasia of the aortic root. I have no idea what any of this means. I did some research and because of my age, 72 and family history by brother also has an aneurysm. I seem to be a candidate for a procedure known as coiling. I also took a fall three years ago and hit my left temple on my night stand and passed out was taken to the ER. They did a CT scan but it did not show anything then. I'm so scared I feel like a walking time bomb!!

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Hello @bluerose72 and welcome to Mayo Connect. I'm so glad that you found this online patient support group.

I can certainly understand your concern regarding this aneurysm, any of us would find that disturbing. Have you had any symptoms related to this aneurysm? I'm thinking of headaches/migraines, dizziness, nausea, etc.? If you read through the other posts in this discussion you will see that many Members have aneurysms and their doctors take a wait and see approach. I would encourage you not to worry (I know that this is easier said than done) until you see the neurologist. At that time you will have a better idea of the nature of this problem and what your treatment options will be.

Have you been able to get an appointment with the neurologist yet? Will you post again when you have an appointment scheduled and if you have any other questions?

REPLY

I have been diagnosed with a 2mm. infundibulum, the Neurologist told me it's different than aneurysm. May the infundibulum be treated? I don't have headaches, but I'm very anxious person, I will have a new CTSC and MRI at the beginning of 2021 the Neurologist will check how it's going.

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@mirthy21

I have been diagnosed with a 2mm. infundibulum, the Neurologist told me it's different than aneurysm. May the infundibulum be treated? I don't have headaches, but I'm very anxious person, I will have a new CTSC and MRI at the beginning of 2021 the Neurologist will check how it's going.

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Hi @mirthy21, welcome to Mayo Clinic Connect. I can understand your concern.

The pituitary gland, located at the base of the brain, is connected to the hypothalamus by a small stem called the infundibulum (or pituitary stalk). Infundibular dilatations (IFDs) are conical, funnel-shaped pouches at the origin of cerebral arteries, and can be difficult to distinguish from an aneurysm. According to this journal article, "the dilatation should be considered as a possible aneurysm only when it measures more than 3 mm in diameter." https://pdfs.semanticscholar.org/6b3b/ce7eae2263f123756c1fd3b27cf087d64abe.pdf

I moved your question about whether an infundibulum can be treated to this existing discussion where members like @kimbo @angie4 @kariulrich @lilcountry @kmaureenc21 @hopeful33250 and talking about options.

It sounds like your neurologist is actively monitoring the infundibulum for the time being. Were any treatment approaches discussed?

REPLY
@bluerose72

Hello I'm new to this blog and was just diagnosed with a 8mm aneurysm left intracranial artery, I was referred by my vasuclar surgeon to see a neurologist but could not get an appointment due to the holiday so I have to call back tomorrow. It all started with a lump on my left carotid artery and my ppo sent me to a vascular surgeon who ordered a ct scan of my neck and a cta of my brain. The lump showed a 3.3 cm ectasia of the aortic root. I have no idea what any of this means. I did some research and because of my age, 72 and family history by brother also has an aneurysm. I seem to be a candidate for a procedure known as coiling. I also took a fall three years ago and hit my left temple on my night stand and passed out was taken to the ER. They did a CT scan but it did not show anything then. I'm so scared I feel like a walking time bomb!!

Jump to this post

Hello @bluerose72,

Several months ago you posted about seeing a vascular surgeon regarding a 3.3 cm ectasia of the aortic root. I was just wondering how you are doing now. Did you have the coiling procedure that you discussed in your post?

I look forward to hearing from you. Will you post an update when it is convenient?

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