I had a good appointment with the neurosurgeon today. He says that even though the annie is larger than we thought at 8mm, it’s still officially small and not likely to rupture (less than .5% per year). He wants me to have a CT angiogram in a year to make sure it’s not growing. That’s just a CAT scan with dye—nothing invasive like the full-blown angiogram I had in April.
He says it is located within the cavernous sinus, which means it is protected by bone. That makes it less likely to rupture, but also more difficult to repair through open surgery, since you have to actually remove the bone to get at it.
Because the ophthalmic artery is at the base of it, it can’t be coiled in an endovascular procedure. My neuro-opthalmalogist was of the opinion that it couldn’t be clipped without killing the eye, but the surgeon says it is possible, just a 5% chance of that happening. BUT, there is a new procedure that was recently approved for carotid and basilar annies that will likely be approved in the next few years for the ophthalmic ones. It’s called the pipeline embolization device. I’ve only read a very little bit about it so far. If we decide to treat it once that is available, it is one of those endovascular procedures—through the arteries, not the skull and brain, so that is good news.
Both he and the ophth are certain the annie has nothing to do with my eye pain, so I’ll still need to try to find a medicine that will work on it, or some other cause or treatment. Since the annie isn’t involved, that is further reason not to treat it.
The surgeon asked me more about my eye pain, and we talked about the meds I had tried. He wondered if my MS neuro was treating me for that that, and I told him it was the neuro-ophth. He is going to request her records. That opened up a conversation about probably switching neuros, and the med school where he teaches has an MS specialist that I think I will try to switch to. I've been going out of network for the last two years and spending thousands of dollars for MRIs and appointments that don't lead anywhere--except that the wonderful nurse practitioner who ordered the MRA discovered my aneurysm. If I'm going to spend thousands on annual CT angiograms, I may as well get in with a neuro who is in network and get me some freebies. And maybe better answers.
So, the self-pity party is over for now, and I will have to stop treating the aneurysm with ice cream and chocolate. On the other hand, it seems to be working. Hmmmmm. I might need to do some more research on that one.
I get to have my dental implant tomorrow, finally, and I will have a real fake tooth in a few months. So things are relatively peachy.