Four years ago I had two brain surgeries to clip an ophthalmic artery aneurysm. As the aneurysm base was located in an area deep into the skull base, total clipping was not allowed. Therefore, after the first surgery, scar tissue formed pushing the residual aneurysm and clips up and into the left optic nerve. Consequently, a repeat surgery was performed, removing old clips and re-positioning new clips closer to the base of the aneurysm. The resulting pressure on the optic nerve, plus the trauma to that area, has left me with no usuable vision in the left eye. Over the last four years, I have had progressive loss of what vision remained in the left eye, I have headaches, pain in my eyes, vision that resembles what it would be like to "drive two totally different cars at the same time", my coordination is off (I am constantly bumping into things, stumbling and staggering), I have many episodes where I feel like I am about to pass out, and I am nauseated more often than not. Recently, I have been experiencing very sharp pains in my head that come on suddenly, last up to about a minute and then disappear. These occur at least once a day, at no set time. The last one left the whole left side of my face sore for about an hour. Another strange occurence since my surgeries, is that every time I yawn, I get an incredible cramp from my chin and the left side of my jaw down into my neck and shoulder. This cramp lasts for 1-2 minutes. Needless to say, I try not to yawn very often. I had an angiogram done about a year ago, that does show some of the residual aneurysm (9 mm.). But because of the clips and the artifact surrounding them, no clear picture of that area can be seen. My question is, can an MRI be done safely in my situation to be able to learn the status of this aneurysm, or to use as a baseline for future studies? I am having the uneasy feeling that something is going on in there, and no one can tell what it is, or is even willing to try. I have had a sleep deprived EEG done a few months ago, that the doctors seem to disagree on what the results are. I have been having "visual disturbances (seeing things that aren't there, vision that resembles a "burning away" phenomonon, a recent episode happened when I was playing the piano, and the notes started to "fall" off the page. One doctor thought the EEG revealed "a seizure tendency". The other tends to think it is a "migraine disorder". I am experiencing weakness in my arms, and legs, and also have developed a "sideways" rocking motion that involves just my head and also a trembling in my hands and fingers. I hope that you can offer some suggestions on this matter as I have taken it about as far as I can, and no answers or help seem available anywhere. I am currently taking medications to control my blood pressure (has been normal 120/80 for the last 3-4 year) which include Procardia XL, Lopressor, and Maxzide. I was on Dilantin for about a month to see if it would control the "eye disturbances" (which it didn't) and I had so many side effects, it was discontinued. I do take an average of at least six aspirins a day to combat the headaches. Again, any help that you could offer would be most appreciated.
An MRI can be done in a patient with titanium aneurysm clips without distortion of the images. This was precisely the reason for creation of the clips, in that they would be MRI compatible.
Do note what information may be gained by an angiogram or an MRI. An angiogram is the 'gold standard' for evaluating vascular anatomy and will demonstrate an aneurysm with great detail. It will not show soft tisues, such as brain parenchyma, all that well. An MRI, however, will demonstrate the brain tissues quite well, but won't be as good in terms of the vascular anatomy.
Speak to your surgeon about your present troubles and ask whether he thinks something can be done. There may be some further compression of local structures causing your pain. The clips may migrate some after surgery. Opthalmic artery aneurysms can be very challenging for any surgeon to treat due to their location and difficulty in getting good placment of the clip.
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