Ther my mom was diagnosed with incidentally identified wide…

Question

This answer was rated:

★★★★★

Ther my mom was diagnosed with incidentally identified wide…

Hi ther my mom was...

Hi ther my mom was diagnosed with incidentally identified wide neck left ophthalmic segment aneurysm. Last year MRA showed 4x4.7mm medially projecting aneurysm arisinf from the left internal carotid artery at the origin of the left opthalmic artery. No other circle of willia aneurysm is indentified. Again noted is fetal origin of the right posterior cerebral artery. Brain is normal, cortical gray white differentiation is intact. No focal gray or white matter lesion.
This year MRA showed 4x5mm.
Lately she has on and off pain in the back of the base if the head. Her pain becomes a whole headache if she doesn't take tylonol. She also said at times both of her eyes feels heavy at times this is rare though.
Please advise us what should we do? Looking for a second opinion. Our neurologist said its stable in size and no surgery needed at this time. Is this so? And isn't the anuresym grew? Is this growth consider stable of 0.3 mm? And what can cause her the back of the base of the head skull? Our dr also said this is a saccular anuresym.

Show Less

Ask Your Own Neurology Question

Customer reply replied 7 years ago

Is Advil ok to take. Since I can't take tylonol because of my liver condition? If not what else can I take? So what is the likely hood it will grow bigger in the later years

Customer reply replied 7 years ago

Thank you. And if I need surgery in the future. Is this hard where the location of my aneurysm? Thank you dr.

Customer reply replied 7 years ago

the pain in the back of the head. She said its the base bone part of the head not the neck. is this cause by the aneurysm? Because lately the pain about 5/10 and started in the morning and become a whole headache in the late afternoon. She said its tender to touch and if she states it started there as a pain of achy and throbbing. She's been sensitive to light. And sensitive to heat and cold. What can this possibly be. She can't sleep last night do to pain

Neurologist: Dr. Frank, Board Certified Physician replied 7 years ago

Hi. One thing this can be is Greater Occipital Neuralgia. It is a aching throbbing pain associated with strange sensations on the back of the scalp (tender to touch??) and it should be one side of the head, not cross the midline to the other side.
I will leave you a webpage on GON. The treatment is to inject the area where the nerve exits under the fascial layer of the scalp with a mixture of marcaine (lidocaine) and steroids (methylprednisolone) called a GON block. A Neurologist will do this for her in the office.
Please get back to me to discuss this further, and also remember to rate my service, as that is how I am compensated for my work. Dr Frank T
http://www.hopkinsmedicine.org/neurology_neurosurgery/specialty_areas/headache/conditions/occipital_neuralgia.html

Dr. Frank, Board Certified Physician

Category: Neurology

Satisfied Customers: 9,000

Experience: Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.

Verified

Dr. Frank and 87 other Neurology Specialists are ready to help you

Ask your own question now

Customer reply replied 7 years ago

She said it started at the back of the head in the bony part and it will get worse to the left or sometimes right or sometimes both sides.

Neurologist: Dr. Frank, Board Certified Physician replied 7 years ago

you would have to rate my service at this point.

Customer reply replied 7 years ago

is what she have still GON or her aneurysm or something else? Thank you for your wonderful feedback

Was this answer helpful?

Yes

No

How JustAnswer works

Describe your issueThe assistant will guide you

Chat 1:1 with a neurologistLicensed Experts are available 24/7

100% satisfaction guaranteeGet all the answers you need

Neurologist: Dr. Frank, Board Certified Physician replied 7 years ago · Answer 1

Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.
The growth over one year is certainly under the standard of 1.0 mm a year. It is of a dimension range that does not need emergent surgery, that starts around 7 or 8 mm size.
the pain in the occiput is cervical muscular spasm pain, not related to the aneurysm, or the primitive posterior cerebral artery, which is just a variant. The pain comes from the neck and ascends to the insertions of these muscles in the back of the skull. It is tension type headache pain or from arthritic changes in the cervical spine. Treatment with NSAID medication, massage, should help.
Please get back to me if you have further questions, please rate my service. Dr Frank T

Neurologist: Dr. Frank, Board Certified Physician replied 7 years ago · Answer 2

Advil is fine to take for this problem. If there is no family history of cerebral aneuysms, or subarachnoid hemmorhage leading to death, you need to watch this yearly. The rate of growth is approx, 1 mm per year max, so eventually you may need surgery as it gets up to 8 mm size. They do not all grow, there are many variables to determine if they will grow, and those variables are only available from autopsy, looking at the blood vessel, so you cannot say. From autopsy studies, more than 6% of us have them, and we all don't die from them. So it really just needs to be watched occasionally.

Neurologist: Dr. Frank, Board Certified Physician replied 7 years ago · Answer 3

Your aneurysm is at a standard location, off the anterior cerebral/ophthalmic bifurcation, and it can be approached either endovascularly by an internal catheter, but it would depend upon that wide neck if that was the best approach, or from a temporal craniotomy, which is more complicated. Yes, I would say this is a hard surgery, and the risks of surgery are substantial. It should not be done until the risk of hemmorhage mandates that need.

Neurologist: Dr. Frank, Board Certified Physician replied 7 years ago · Answer 4

this is unlikely to be GON based on the fact that it changes sides, but more likely to be cervicogenic headache from spasm. this is an effect of arthritis in the cervical spine, causing spasm in the neck muscles and resultant pain. If this is a chronic problem, you could try trigger point injection therapy into the cervical muscles, or epidural steroid injection therapy into the cervical area if she has degenerative disc disease of the cervical spine. there is even Botox injections into these muscles for chronic pain.
A Neurologist or a pain management doctor that does injection therapy could help her with these problems.

Ther my mom was diagnosed with incidentally identified wide…

How JustAnswer works

JustAnswer in the News:

What Customers are Saying:

Meet the Experts: