Infundibulum or aneurysm?

Posted by lilcountry @lilcountry, Jul 15, 2018

Hi. So last week, my neurologist gave me the results of my MRI and MRA and said they have found what is either an infundibulum or an aneurysm, they can’t be sure which without doing a cerebral angiogram. It’s over 3mm in size. I originally went to him because I had been having “spells” as we had been calling them, where I seemed to zone out, almost like a seizure but without shaking, a non epileptic seizure if you will. He insists this has no bearing on it and seems to think those are triggered only by stress. He also showed me numerous white “spots” all over the MRI which he said were probably just from my migraines. A friend of mine had the same white “spots” on hers and her doctor did not brush it off as migraines. I’ve never had any problems like this before, and to be honest I am scared. Should I get a second opinion? Any advice would be appreciated.

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Hi @lilcountry, welcome to Connect. It is certainly understandable why you would be scared. Either one of these diagnoses would be a lot to digest and it is OK to feel nervous about either. You may find the following discussion worth your time to read through, https://connect.mayoclinic.org/discussion/infundibulum-in-my-brain/. @lilcountry, if you don't mind sharing, what course of action did your current provider recommend moving forward with this diagnosis?

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@JustinMcClanahan

Hi @lilcountry, welcome to Connect. It is certainly understandable why you would be scared. Either one of these diagnoses would be a lot to digest and it is OK to feel nervous about either. You may find the following discussion worth your time to read through, https://connect.mayoclinic.org/discussion/infundibulum-in-my-brain/. @lilcountry, if you don't mind sharing, what course of action did your current provider recommend moving forward with this diagnosis?

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He is scheduling a cerebral angiogram coming up to determine if it is an infundibulum or an aneurysm. He said if it’s an infundibulum he would leave it alone, and if it’s an aneurysm, he would see what kind it was and determine what to do after he sees it. He increased the dosage of my topamax for preventative medication for migraines and told me to keep going with esgic as needed for when migraines became too much to bear. As for the “spells” he really had no answer except maybe it was stress related.

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Hello @lilcountry

It sounds as if your doctor is being thorough in his follow up. You stated in your post above, "I’ve never had any problems like this before, and to be honest I am scared. Should I get a second opinion?"

Please know that it is always your right to get a second opinion. The second opinion would best come from a large university medical center (where there are a lot of specialists who consult and work as a team) or research-oriented hospital such as a Mayo Clinic facility (there are three, in Minnesota, Florida and Arizona).

Please keep in touch, I look forward to hearing how this problem is being resolved and what you are doing to reduce your anxiety about this diagnosis.

Teresa

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@hopeful33250

Hello @lilcountry

It sounds as if your doctor is being thorough in his follow up. You stated in your post above, "I’ve never had any problems like this before, and to be honest I am scared. Should I get a second opinion?"

Please know that it is always your right to get a second opinion. The second opinion would best come from a large university medical center (where there are a lot of specialists who consult and work as a team) or research-oriented hospital such as a Mayo Clinic facility (there are three, in Minnesota, Florida and Arizona).

Please keep in touch, I look forward to hearing how this problem is being resolved and what you are doing to reduce your anxiety about this diagnosis.

Teresa

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I will definitely keep in touch! I am hoping they find an answer for it all. I’ve just never had to see a neurologist before and when he mentioned having to “poke around in my peanut” as we are calling it now, it has me a bit rattled. Thank you for the advice, just not sure if I should bother with a large university center or if I am overreacting here.

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Hello @lilcountry

In my opinion (and I am not a medical professional – just a patient like yourself and other Members on Connect) you are never over reacting if you choose to get a second opinion, especially if you get it from a research oriented facility. There have been many times that I have trusted what I've been told by doctors and have not reached out for that second opinion and later found that my reluctance worked against me. So, if your follow up with your current doctor still leaves you with doubts or questions – go for that second opinion.

Please keep in touch, I look forward to hearing from you again.

Teresa

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A 1.9 mm aneurysm versus infundibulum projects caudally from the supraclinoid segment of the internal carotid artery.
Could someone help me with this thought.
I have an aneurysm on the left side and this new diagnosis on the right side.

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@rebhof

A 1.9 mm aneurysm versus infundibulum projects caudally from the supraclinoid segment of the internal carotid artery.
Could someone help me with this thought.
I have an aneurysm on the left side and this new diagnosis on the right side.

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Hello @rebhof and welcome to Mayo Clinic Connect. You will notice that I have moved your post into an existing discussion that you can find here: https://connect.mayoclinic.org/discussion/infundibulum-or-aneurysm/

I'm wondering if your first sentence is from your medical chart and you are trying to decipher its meaning?

I am not a doctor, but if I take apart the words, this is what I get:
A 1.9 mm aneurysm versus infundibulum = The main importance of an infundibulum is that it may be mistaken for a saccular (berry) aneurysm (which is rounded and has the branch at its base). An infundibulum in most cases measures less than 3 mm. Unlike an aneurysm, an infundibulum is not believed to be a risk for rupture and subarachnoid hemorrhage

…projects caudally = relating to or being a tail

…from the supraclinoid segment = The supraclinoid (carotid-ophthalmic) segment of the internal carotid artery (ICA) under the Bouthillier classification is defined as the segment between the ophthalmic and posterior-communicating arteries.

…of the internal carotid artery. = The internal carotid arteries are branches of the common carotid arteries that bifurcate into the internal and external carotids at the level of the carotid sinus. [2] After this bifurcation, the internal carotids traverse through the base of the skull to reach the vital organs that they supply.

Does dissecting that help you better interpret the meaning? Have you asked your neurologist for a layman explanation?

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@amandajro

Hello @rebhof and welcome to Mayo Clinic Connect. You will notice that I have moved your post into an existing discussion that you can find here: https://connect.mayoclinic.org/discussion/infundibulum-or-aneurysm/

I'm wondering if your first sentence is from your medical chart and you are trying to decipher its meaning?

I am not a doctor, but if I take apart the words, this is what I get:
A 1.9 mm aneurysm versus infundibulum = The main importance of an infundibulum is that it may be mistaken for a saccular (berry) aneurysm (which is rounded and has the branch at its base). An infundibulum in most cases measures less than 3 mm. Unlike an aneurysm, an infundibulum is not believed to be a risk for rupture and subarachnoid hemorrhage

…projects caudally = relating to or being a tail

…from the supraclinoid segment = The supraclinoid (carotid-ophthalmic) segment of the internal carotid artery (ICA) under the Bouthillier classification is defined as the segment between the ophthalmic and posterior-communicating arteries.

…of the internal carotid artery. = The internal carotid arteries are branches of the common carotid arteries that bifurcate into the internal and external carotids at the level of the carotid sinus. [2] After this bifurcation, the internal carotids traverse through the base of the skull to reach the vital organs that they supply.

Does dissecting that help you better interpret the meaning? Have you asked your neurologist for a layman explanation?

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My neuro still has not replied to my calls. I just don't understand why they say aneurysm versus infundibulum.
They say they are different.But when you have an aneurysm on the left side and an versus on the right that wasn't there several months ago you get concerned. I have autoimmune disorders with 2 prior strokes. I am concerned.

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@rebhof

My neuro still has not replied to my calls. I just don't understand why they say aneurysm versus infundibulum.
They say they are different.But when you have an aneurysm on the left side and an versus on the right that wasn't there several months ago you get concerned. I have autoimmune disorders with 2 prior strokes. I am concerned.

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@rebhof have you been able to leave a message for your neuro? Do you have a portal you can use to email them directly?

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I have left several messages to him direct with no answer.

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@rebhof

I have left several messages to him direct with no answer.

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Hi,
If helpful at least sometimes They just watch things of that smaller size (or would need an angio they might not do) (since they would watch it either way )to confirm what it is between the two. However talk to your doctor of course for specifics. But take a deep breath as they may not know/tell you specifics unless they do more testing. Hang in there. The vs. typically means they can’t confirm what it is between the two. I understand this can be frustrating. The small size is a good thing.

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Get a second opinion at a Large well know University hospital that has a specialist that can address your situation .Don’t think twice about!

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