Signifigance of size as it relates to aneurysms

Could you please differentiate between the significance of sizes of cerebral vs. aortic aneuryms?  I have a 14 mm aneurysm in my Right Posterior Communicating Artery.  Are my cerebral arteries the same size as my aortic arteries?  I have learned some very important family information, my mother died of an aortic aneurysm, my grandmother died from a carotid aneurysm and my father who I recently found has veins stripped from his arm and replaced in his leg, I also had a maternal uncle who lost a leg to circulatory problems in 1963.  I have been told there are significant differences relating to sizes of aneurysms vs. where they are and the risk of rupture.  A 2.5cm aneurysm in a brain artery per my internet research is considered giant, a 5 cm aortic aneurysm may be considered giant, but there is considerable differentiation because of size I think or I hope to be able to resolve this in my mind. Could you please help me understand the difference in size as it relates to risk of rupture in the aortic, corotid and cerbral arteries? Thank you in advance.

[CCF Neuro[P] MD, RPS]

Dear Mr. Hall:

Sorry to hear about your aneurysm.  Yes, there are some differences.  Aortic aneurysms can be the result of hereditary factors or acquired (ie. hypertension).  There are also some evidence that cerebral aneurysms are inherited.  The major difference is that peripheral aneurysms are easier to fix as they can be looked at easily during surgery.  The kind in the brain are very difficult because of the skull that prevents getting to them to do procedures. All aneurysms have the potential to rupture.  Depending on the place in the brain and the number we usually try and figure out if they need to be fixed.  The size is definitely a factor, location is another factor, age of the patient, symptoms from the aneurysm, etc.  In addition, if you are a smoker, drink alcohol, use recr. drugs, have a heart condition, hypertension, diabetes, these all figure into the equation.  Yours is seemingly small, that is good.  However, if you are having symptoms or are at risk then you may consider seeing a good neurologist/neurosurgeon.  Aneurysms can also grow in size so this is another factor to consider.

I would go see a neurologist or neurosurgeon and just get a feeling about your aneurysm and risk factors.

Sincerely,

CCF Neuro MD