I am a 25 year old male who has been diagnosed with a Giant Cerebral Aneurysm. It is located in the right part of my brain and is 22 mm in diameter. It is wrapped tightly by about 4-5 smaller veins. It occurs where the veins split ( I forget the terminology). It is still a Grade 0 aneurysm ( meaning no hemorrhages yet!).
I have been having headaches over the past 3-6 months that would last about a week. None of them were very severe, but they just came on suddenly and no over-the-counter headache pills would relieve them. Anyway, after the first time that I could not attend work, my wife scheduled an appointment with our family doctor. After trying to detect what brought on the headaches ( with no success ), he immediately wanted to rule out the worst case scenarios, so he scheduled an MRI the next day.
It was just last week (Thursday, October 2nd) that I got my MRI done and within hours my doctor was on the phone demanding that I come over to this office IMMEDIATELY! Needless to say, I was in a state of panic. I am happy that there were no policemen on the road at that time. Anyway, he explained that they had detected an aneurysm. So I met a neurologist that same evening and was informed that it would most probably be removed surgically in a few weeks. But I had to get an angiogram.
I contacted my family, who are in India, and started to make plans for bringing my parents here. I am extremely happy that neither my wife nor I broke down or started thinking negatively.
That same night, being an information hungry, frequent web-user, I found this site, among many others, and learnt as much about aneurysm's as I could. I was pleased to learn that this was a much more common disease/sickness than I had thought. The neurologist I visited told me that it would most definitely be a surgical removal, so I ignored most of the other techniques, since they were relatively new.
I did not stop there, I contacted whoever I knew and was referred to the best neurosurgeon in my area (Ohio). However, I did not want to contact him without my angiogram (since that most accurately describes the size, location etc. of the aneurysm).
So on Monday, October 5th, I went an got an angiogram done. I picked up the results yesterday (Tuesday, October 6th), but could not meet the recommended (best) vascular neurosurgeon. I finally did meet him today and what he told me has really shaken me.
He told me that I have a Giant aneurysm (22 mm in diameter) and that it was very complex, in the sense that there are about 4-5 veins tightly wrapped around it. This would most probably remove any chance of direct surgical removal. Even though he has been practicing this for over 20 years, he may not be able to do it. This really made me scared. He told me about a total of 5 different methods of attacking this aneurysm. Each of which I have briefly stated below:
Don't do anything at all. Most probably not recommended due to my (young?) age. (25 years).
Direct surgery i.e. clipping the aneurysm. Very complex in my case.
Coil insertion. He wanted to contact the best radiologist he knew (in Buffalo, NY) and ask him for his opinion. I asked him "weird" questions like, suppose my head is badly shaken, like in the case of an automobile accident, what would happen? Would the aneurysm be displaced, could it split - sending out all the coils onto my brain? I know this is a stupid question, but he said that one could not tell what would happen, though the chances of this happening are remote. This is because coil insertion was a technique invented only 5 years ago (relatively new in the medical field).
Gradual slowdown of the blood in the vein that contains the aneurysm. This would cause a natural clot ( I think, thrombus) to develop in the aneurysm, due to the reduction in the speed of the flow of blood through the aneurysm.
A bypass (I think it is called an inter cranial/extra cranial bypass) - similar to a bypass surgery of the heart.
The part that pleases me the most about this doctor, is his approach to the problem and his humility. He said that he would consult with other doctors, whom he considers the best in their field, and ask their opinions in this situation. This is in spite of the fact the he has been operating on aneurysms for the last 20 years on a frequent basis. He even encouraged me to get as many opinions as I could. Any information, in my case, would help.
I found a listing of the best Medical Center's in the US, for each specific field, on the 'US News and World Report' web site but this does not give me a listing of the best doctor to contact for my particular problem.
What I had considered a "routine" procedure has turned out to be scary, since even the doctor I considered an expert, is turning to other people for help. If he can, so can I - Could anybody please give me recommendations to neurologists/radiologist/"any"–ologists who can help my case? Anyone who has worked with complex giant aneurysms? Anyone who had time to make their OWN decision on which procedure was to be adopted, please explain how you went about making the decision.
The decision on which procedure is to be followed will be taken by ME (!!?!!), since there is a very high percentage of risk in all the procedures (for my case). We need to arrive at this decision by the end of next week. So please respond as soon as possible with any pointers to a doctor, hospital, anything that can help!
Thanks,
Sanjeev.