Brief Answer:
Consultation

Detailed Answer:
Hi XXXXXXX thanks for asking from HCM.


I can understand your concern. I have read the reports and discharge summary.

Doctor has mentioned that AVM was 80% embolized. It means 20% is still persisting and it can give rise to new AVM. As such, Onyx embolisation can cure completely only 50-60% cases of AVM. But in your patient, residual is already present, so chances of recurrence is high and it may take 3-7 years to form new AVM.

Now coming to left PCA aneurysm coiling, if it was coiled completely, chances of recurrence of aneurysm is less than 5%. Aneurysm usually recur after years and may recur even after 10-15 years. No time is defined as such. There was one ICA aneurysm that was left as such and doctor has mentioned that it involuted. If it is so, it means it was related to AVM flow. It must have completely healed by now. It can recur only if AVM attains sufficient size.

Prognosis depends upon few factors like
: AVM size and grade (Sptzer XXXXXXX 1-5)
: Number of arterial feeders
: Number of venous drainage
: Presence of aneurysm - It is considered bad. As aneurysm can rupture and patient may deteriorate. But in your patient, aneurysm had been coiled. So do not worry.
: Age - He is 40 years old. Young age is considered good prognosis.
: Any history of bleed - AVM can bleed in 7% cases. I don't know if it bled in your patient. But if it bled, it means it has a tendency and it can rebleed if it recurs.

As now both aneurysm and AVM have been treated, so complications can not occur. Single fearsome complication is recurrence. Kindly follow few tips

: Maintain regular follow up of treating surgeon
: Do regular CT Angiography or MR Angiography every 6 months to rule out any recurrence for first 5 years and then yearly.
: Be careful regarding antiepiletic medication. Do not stop on your own. Ask doctor to taper it only if there is no epilepsy in last 3-5 years. He may advise EEG before stopping drugs.
; No smoking, alcohol, drug abuse, if any. It increases chances of aneurysm recurrence.
; Control of Diabetes Mellitus and hypertension is must.

Hope it will help you. If still in doubt, do let me know.

Thanks. Take care.

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