Is it normal to find aneurysm in CT scan of brain at an age of 70?

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Posted on Fri, 19 Jun 2015 in Brain and Spine
Question: My mother is 70 and in very good condition for her age. She recently had a stroke and the neurologist ordered another more advance CT scan with contrast. Everything was good but they incidentally found a 3mm aneurysm. The doctor said it was almost not even worthy of follow up and he would suggest having my primary doctor do another scan in a year. He said it was not much to worry about and if he sent her to a neurosurgeon he would tell her the same thing. Obviously we are worried, however.
My question are the following.
1. Is it fairly common for a 70 year old to have such a finding on a scan?
2. Is this as trivial as the neurologist seems to imply?
3. Do they normally grow and become dangerous at that age?
4. Are there any physical activities she should not do, she is a farmer
and regularly lifts and bends over.
5. Does the Plavix greatly increase the risk of a bleed?
doctor
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
Your neurologist advice is correct.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted the symptoms and MRI findings of your mother.

1. It is not uncommon to find an aneurysm, when a brain scan is done for other problems, referred to as incidental finding of an aneurysm.

2. It is a small aneurysm and the risk of rupture is less than 2% per year.

3. They do not normally grow in size.

4. She should be able to do all normal activities.

5. Plavix does not increase the risk of bleed.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sudhir Kumar 7 hours later
Thanks! In doing my research I am confused by the percentages. If it is about a 2% chance a year, to me that would mean a 2% chance over her lifetime. However, as I understand it is cumulative, so does that mean if she lives to be 85 she will have a 30% chance it will bleed in her lifetime. The 2% is rather comforting but when they add the "per year" it gets concerning...both for the chance of recurrent stroke and aneurysm bleed. Her mother is currently 93, so if she were to live that long her risk would be very high??? Thanks!
doctor
Answered by Dr. Sudhir Kumar 23 minutes later
Brief Answer:
The risk is 2% per year.

Detailed Answer:
Thank you for getting back.

The risk is generally 2% per year. So, if a person lives for 15 more years, then, there would be 30% risk of bleeding. However, the risk is lower for smaller aneurysms. So, in her case, the risk would be much lower than 2% per year (could be 0.5-1% per year; exact incidence in smaller aneurysms are not known, as most often they are incidentally picked up).

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sudhir Kumar 50 minutes later
Ok, I have one more question. My mom is very physically active
and has never been sick in her life. Now she has had a stroke
and has an aneurysm, but hasn't slowed down a bit. It is probably
good for her to be as active as possible, right? They can't find any risk
factors for this or the stroke, is it possible stress can cause these
things (her son is bipolar, husband just had lung cancer, and mother
just recovered from 2 hip breaks and a broken arm...she also still
works) Don't know how to limit stress though, if you have it you have
it.
doctor
Answered by Dr. Sudhir Kumar 3 minutes later
Brief Answer:
It is good for her to be active.

Detailed Answer:
Thank you for getting back.

Yes, it is good for her to be active, as it helps in faster recovery and limits the disability, if any.

Stress is a risk factor for stroke. It should be minimised as much as possible.

Regarding other risk factors, I am sure they have been ruled out in her:

High Sugar
High BP,
High Cholesterol,
High Homocysteine,
Low vitamin D level,
Heart disease

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sudhir Kumar 1 hour later
Thank you so much this has been very helpful I have one last thing.
I think we are going to be paranoid now that she has two brain
issues to watch for sign of problems. If she gets flu like symptoms
or even a moderate headache should she always go to the ER and
rule out serious problems. Or will it be very obvious that something
is wrong. Certainly don't want to underestimate a possible sign but
don't want to live in complete parinoia. Thanks and I will rate right
away.
doctor
Answered by Dr. Sudhir Kumar 2 hours later
Brief Answer:
Following symptoms should be taken seriously

Detailed Answer:
Thank you for getting back.

She should not be rushed to ER for any headache or flu like symptoms.

Following symptoms should be taken seriously:

For stroke- asymmetry of face, slurred speech, weakness of arm or leg, imbalance while walking.

For bleeding- sudden severe headache with or without vomiting.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Sudhir Kumar

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Practicing since :1994

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