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What Does This CT Scan Report Indicate?
Question: As I mentioned previously, during a CT scan it was incidentally found that my mother has a 3 mm aneurysm of the brain. The neurologist did not think she needed to be referred to a neurosurgeon although he said he would if she wanted to. Is this something that should be followed up with a surgeon or just watch by the primary doctor?
Brief Answer:
A Neurosurgical opinion needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
At least, there is need for a Neurosurgeon consult about this incidentally found aneurysm.
I read your previous discussions and I agree with my colleagues opinions about risk of bleeding and preventive measures about lowering the risk of bleeding.
I didn't catch the localization of the aneurysm, i.e: was the aneurysm located at anterior circulation ( anterior communicating artery, medial cerebral artery, anterior cerebrally artery), or at posterior circulation ( basilar artery, posterior communicating artery, tip of basilar).
Posterior circulation localized aneurysms should be considered more carefully, because they pose greater risks if they rupture.
In my opinion, there is need for a Neurosurgeon opinion to complete the evaluation, after this should be instituted the follow up plan.
Hope this helps. Best regards.
A Neurosurgical opinion needed.
Detailed Answer:
Hello and thanks for using HCM.
I have read your question and understand your concerns.
At least, there is need for a Neurosurgeon consult about this incidentally found aneurysm.
I read your previous discussions and I agree with my colleagues opinions about risk of bleeding and preventive measures about lowering the risk of bleeding.
I didn't catch the localization of the aneurysm, i.e: was the aneurysm located at anterior circulation ( anterior communicating artery, medial cerebral artery, anterior cerebrally artery), or at posterior circulation ( basilar artery, posterior communicating artery, tip of basilar).
Posterior circulation localized aneurysms should be considered more carefully, because they pose greater risks if they rupture.
In my opinion, there is need for a Neurosurgeon opinion to complete the evaluation, after this should be instituted the follow up plan.
Hope this helps. Best regards.
Above answer was peer-reviewed by :
Dr. Prasad
The neurologist was very dismissive about the aneurysm and said to follow up in a year. I don't remember him telling us the location.
1. But in my research I am finding conficting information about a 3mm size aneurysm. Is it common to do a procedure on one this small and are the outcomes of the surgery good? She is 70 but very physically fit and passed all the other tests they did to find risk factors for stroke.
2. I have read there are a lot of false positives, is that true and does she
need another test to confirm?
3. Since the doctors cant find a cause for her stroke, could the aneurysm
be the cause or the result of the stroke.
Thanks, I appreciate you help.
1. But in my research I am finding conficting information about a 3mm size aneurysm. Is it common to do a procedure on one this small and are the outcomes of the surgery good? She is 70 but very physically fit and passed all the other tests they did to find risk factors for stroke.
2. I have read there are a lot of false positives, is that true and does she
need another test to confirm?
3. Since the doctors cant find a cause for her stroke, could the aneurysm
be the cause or the result of the stroke.
Thanks, I appreciate you help.
Brief Answer:
Follow up is sufficient.
Detailed Answer:
Welcome back.
1. A 3 mm unruptured aneurysm usually doesn't need treatment, surgery poses relevant risks. Best treatment ( don't get me wrong, I agree with other colleagues opinion about following up) in such cases is coiling of aneurysm by DSA procedure.
2. The best imaging study with highest specificity about aneurysms is arteriography ( DSA).
3. In rare cases, unruptured aneurysm could be the cause of stroke by producing thrombotic emboli. This possibility needs specialized evaluation by an experienced Neurologist or Neurosurgeon.
If the ischemic stroke resulted from occlusion of same artery with aneurysm location, is highly suspicious that aneurysm was the cau of stroke.
Hope this helps. Best regards.
Follow up is sufficient.
Detailed Answer:
Welcome back.
1. A 3 mm unruptured aneurysm usually doesn't need treatment, surgery poses relevant risks. Best treatment ( don't get me wrong, I agree with other colleagues opinion about following up) in such cases is coiling of aneurysm by DSA procedure.
2. The best imaging study with highest specificity about aneurysms is arteriography ( DSA).
3. In rare cases, unruptured aneurysm could be the cause of stroke by producing thrombotic emboli. This possibility needs specialized evaluation by an experienced Neurologist or Neurosurgeon.
If the ischemic stroke resulted from occlusion of same artery with aneurysm location, is highly suspicious that aneurysm was the cau of stroke.
Hope this helps. Best regards.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thanks...one last thing. I have read many different
statistics on the risk of a 3mm aneurysm rupturing.
Anywhere from .5% to 3% a year. Can you tell
me the estimated risk? As good of shape as she
is in over her lifetime that could add up to a large
risk.
Oh and does bending over or lifting pose a risk...
we are produce farmers and work is hard. Thanks
and I will rate.
statistics on the risk of a 3mm aneurysm rupturing.
Anywhere from .5% to 3% a year. Can you tell
me the estimated risk? As good of shape as she
is in over her lifetime that could add up to a large
risk.
Oh and does bending over or lifting pose a risk...
we are produce farmers and work is hard. Thanks
and I will rate.
Brief Answer:
Risk is about 1% per year, but is related to other factors.
Detailed Answer:
Welcome back.
The mean rupture risk rate of unruptured aneurysms is about 1% per year, but the exact risk rupture rate is related to aneurysm location, wall of aneurysm configuration, ( irregular walls are considered more dangerous ).
The risk is cumulative, or in other words after 10 years the risk is about 10%.
The anatomy of aneurysm is best assessed by arteriography ( DSA ).
Measures to minimize rupture possibility include strict control of blood pressure, avoiding lifting weights, minimizing straining etc.
Hope I helped you.
Take care.
Risk is about 1% per year, but is related to other factors.
Detailed Answer:
Welcome back.
The mean rupture risk rate of unruptured aneurysms is about 1% per year, but the exact risk rupture rate is related to aneurysm location, wall of aneurysm configuration, ( irregular walls are considered more dangerous ).
The risk is cumulative, or in other words after 10 years the risk is about 10%.
The anatomy of aneurysm is best assessed by arteriography ( DSA ).
Measures to minimize rupture possibility include strict control of blood pressure, avoiding lifting weights, minimizing straining etc.
Hope I helped you.
Take care.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
So to clarify it may be a problem for her to lift
boxes of produce around 15 to 20 lbs. Loading
and unloading tents, tables, boxes ect. at the
farmers market she goes to could be a risk?
What about bending over to pull weeds or pick
produce. We do a lot of labor intensive work
on the farm and I am wondering if her lifestyle
needs to be revised for her health. She is
is great shape and enjoys the work, but we need
to know if she could overdo with the job. Should
she somewhat restrict that kind of activity?
boxes of produce around 15 to 20 lbs. Loading
and unloading tents, tables, boxes ect. at the
farmers market she goes to could be a risk?
What about bending over to pull weeds or pick
produce. We do a lot of labor intensive work
on the farm and I am wondering if her lifestyle
needs to be revised for her health. She is
is great shape and enjoys the work, but we need
to know if she could overdo with the job. Should
she somewhat restrict that kind of activity?
Brief Answer:
Work should be restricted somewhat.
Detailed Answer:
Hi again.
it is not good for a person if he/she stops everyday activities suddenly.
This can affect all of her wellbeing including psychological status.
All I'm saying there is need for a new equilibrium in your mother's lifestyle and work.
Let's put it this way: if there is need to lift 15 to 20 lbs boxes, your mother can lift the 15 lbs ones and you others have to lift 20 lbs ones.
Reducing work time is necessary too, by getting longer pauses eg.
Hope I helped you. Take care.
Work should be restricted somewhat.
Detailed Answer:
Hi again.
it is not good for a person if he/she stops everyday activities suddenly.
This can affect all of her wellbeing including psychological status.
All I'm saying there is need for a new equilibrium in your mother's lifestyle and work.
Let's put it this way: if there is need to lift 15 to 20 lbs boxes, your mother can lift the 15 lbs ones and you others have to lift 20 lbs ones.
Reducing work time is necessary too, by getting longer pauses eg.
Hope I helped you. Take care.
Above answer was peer-reviewed by :
Dr. Prasad
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