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#MayoClinicNeuroChat about Brain Aneurysms

Posted by @audreylaine, Thu, Jan 26 12:40pm

Dr. W. David Freeman, neurologist, and Dr. Rabih Tawk, endovascular neurosurgeon talk about brain aneurysms.

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love2dance
@love2dance

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Posted by @love2dance, Sun, Jan 29 5:39pm

How long does memory loss and personality last after surgical clipping of unruptured aneurysm?


Colleen Young, Connect Director
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Posted by @colleenyoung, Sun, Jan 29 7:41pm

Welcome to Connect, @love2dance.
I moved your question to this discussion thread about brain aneurysms. On Feb 8, Dr. W. David Freeman, neurologist, and Dr. Rabih Tawk, endovascular neurosurgeon, will be hosting a live Q&A chat about brain aneurysms. I think your question would be a good one to ask them.

Love2Dance, what personality changes have you noticed since the surgical clipping? When was the surgery?


love2dance
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Posted by @love2dance, Tue, Jan 31 11:41am

Surgery was Jan 24 2017. No emotion and unable to get sentences with right words. Off the wall statements. Not recognizing friends from our dance group when they send cards.

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Colleen Young, Connect Director
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Posted by @colleenyoung, Tue, Jan 31 5:35pm

@kariulrich and @deanatay, did you have any issues with memory or personality changes that you could share with Love2Dance?


Kari Ulrich, Volunteer Mentor
@kariulrich

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Posted by @kariulrich, Tue, Jan 31 8:00pm

Hi Lovetodance, I have small aneurysms that are monitored and have not had to have a coil or clipping. Do you know where the ruptured aneurysm was located? I am sure that may have something to do with the symptoms you are experiencing, but I would advise you to call your neurosurgeon and ask that question specifically. Did they tell you at discharge that your symptoms would improve overtime. I know the healing process can take time, but I would give your doctor a call just to be sure. If your having a difficult time remembering all your discharge instructions make sure you read them several times and have a family member go over them, so you know what post op signs and symptoms to be watching. Keep us posted!


love2dance
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Posted by @love2dance, Wed, Feb 1 10:32am

The aneurysm was in COM artery This Is my husband and he is in sub acute care rehab facility getting Ot Pt and speech therapy. Dr said he has brain swelling. It has been 1 week. His Ot and pt are going good but memory and communicating skills need lots of work.

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Posted by @audreylaine, Thu, Feb 2 9:03am

Hi, @love2dance. I took your question to Dr. Freeman, who says, “This is usually always temporary from anesthesia, unless the aneurysm is near/affecting brain structures of Papez circuits or some other complication during surgery such as bleeding (delicate aneurysms) or other problems. These are discussed prior to surgery with the patient so they have a clear understanding of the risk vs benefit. Only aneurysms that pose a benefit of surgery and greater than surgical risks are operated on. For example, if an aneurysm clipping poses a 5% or less risk of the surgery but a 10% risk of rupture, this is how surgery is discussed with the patient (‘risk/benefit ratio’) in which the patient makes the decision with their doctor.”

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Colleen Young, Connect Director
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Posted by @colleenyoung, Sun, Jan 29 7:47pm

@kariulrich @billieb @sunshine44 @useless @dannyreed,
On Feb 8 at 12 pm CT, Dr. W. David Freeman, neurologist, and Dr. Rabih Tawk, endovascular neurosurgeon, will be hosting a live Q&A chat about brain aneurysms. You can watch the video right here in this discussion on Connect. I hope you can join us.


Kari Ulrich, Volunteer Mentor
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Posted by @kariulrich, Sun, Jan 29 8:56pm

Thank you for this heads up! I will make sure my brain aneurysm peeps know!


deanatay
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Posted by @deanatay, Mon, Jan 30 2:16pm

What is common treatment for a 3mm and a 5mm aneurysms that are in the carotid artery behind both eyes


Colleen Young, Connect Director
@colleenyoung

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Posted by @colleenyoung, Tue, Jan 31 5:57pm

Good question @deanatay!
Welcome to Connect. Have you had any treatment?

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Posted by @audreylaine, Thu, Feb 2 9:12am

Hi, @deanatay. I took your question to Dr. Freeman. His answer is below:
This depends on whether the aneurysm is ruptured or not. If ruptured, the treatment would be surgery. If unruptured, 3mm aneurysms are typically monitored or observed since the risk of surgery/intervention can outweigh the short-term/long-term benefits. Aneurysms of 5mm are more likely to be treated surgically, and it depends on the growth rate. Mayo Clinic conducted the ISUIA trial (International Study of Unruptured Intracranial Aneurysm in the New England Journal of Medicine http://www.nejm.org/doi/full/10.1056/NEJM199812103392401#t=article ).
A good rule of thumb for patients is that aneurysms 7mm or greater become greater risk for those carotid aneurysms (ie., ‘behind the eye’), whereas those 4mm or greater in the back of head region (called PCOM, PCA, etc) should be considered for treatment. Those less than 7mm of the carotid should be carefully discussed with their surgeon since this ISUIA should be carefully decided and on other indivualized risk factors, such as age, growth rate, comorbidities and other important factors.
Finally some aneurysms behind the eye are within the cavernous sinus, which is potentially less risky to fix with a newer ‘flow diversion technology’ but again, patients are encouraged to talk about the ‘risk vs. benefit and alternatives’ with their doctors. Mayo Clinic has experts in all these areas and were principle investigators of the ISUIA trial.
Also a recent study lead by Dr Robert D Brown at Mayo and other international investigators called PHASES can help decide in this matter (http://thelancet.com/journals/laneur/article/PIIS1474-4422(13)70263-1/fulltext).

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Kari Ulrich, Volunteer Mentor
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Posted by @kariulrich, Tue, Jan 31 8:13pm

I want to mention that patients diagnosed cerebrovascular Fibromuscular Dysplasia (FMD) are at increased risk of brain aneurysms, so I hope some of our FMD patients will join in on this Neuro Chat. For more information: http://www.mayoclinic.org/diseases-conditions/fibromuscular-dysplasia/symptoms-causes/dxc-20202080

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abissol41
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Posted by @abissol41, Tue, Jan 31 8:42pm

My husband had a rupture in January 2013. He had a coiling then that saved his life. 6 months later at a followup angiogram we learned he needed a clip which he had done in Sept 2013. He was a smoker and high BP. He currently still takes bp meds but recently started smoking again. What are the chances this new/old habit will cause a problem for his aneurysm?

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Kari Ulrich, Volunteer Mentor
@kariulrich

Posts: 221
Joined: Jul 15, 2011
Posted by @kariulrich, Tue, Jan 31 9:07pm

Smoking does increase the risk factor for aneurysms. I hope he can sum up the courage to quit smoking again, I know it easier said than done. You are in my thoughts, this has to be difficult for you. Please know we are here for you. Here is a link for smoking cessation: http://www.mayoclinic.org/healthy-lifestyle/quit-smoking/basics/quitsmoking-basics/hlv-20049487

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