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Confused - conflicting diagnosis

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    Confused - conflicting diagnosis

    Really need some advice. I had a recent CTA with contrast to rule out stenosis of the carotid arteries due to some turbulence found on an ultrasound. The CTA came back unremarkable. As a follow up, my doctor sent me for an MRI/MRA without contrast but at a different facility. The neuro radiologist that read the study reported a possible small aneurysm in the Cavernous segment of the ICA at 1.:mm. He recommended a CTA for further study. I provided him the CTA that was just completed and he issued an amendment to the report stating that what he thought was a possible small aneurysm is in fact an undulating vessel and the MRA exaggerated the curvature. He ruled out aneurysm. I spoke with him over the phone and he was adamant that I do not have an aneurysm. He said this area is a common place for false findings and the CTA was able to rule out aneurysm.

    I had already planned to meet with a neurosurgeon at Cedars Sinai and went ahead with the appointment. I assumed he would state the same however he suggested I do have an aneurysm. He didnít seem to want to listen to me regarding my conversation with the neuro radiologist and insisted I have an aneurysm. His explanation was he ďis the aneurysm expertĒ and that is what he does. He didnít seem very interested and told me itís in an area that doesnít matter and the size is of zero concern.

    Iím really confused. The neuro radiologist who initially suggested aneurysm seemed very sincere and confident about his conclusion of no aneurysm. However, Cedars Sinai has a good reputation and specifically this doctor is highly regarded. I just feel that he made up his mind that I had an aneurysm and because he saw no threat due to location and size he was not inclined to spend time ruling out something he thought was of no threat.

    Thoughts and advice would be greatly appreciated.

    ((((((Runner419)))))) ~


    I have no experience with aneurysms. Given that two physician have opposing diagnoses, perhaps you should consult a third physician. Unless there are other possibilities than these two, I would suspect that a third physician would concur with one of the other two.

    Wish I could be more helpful.

    Love & Light,

    Mom to Jon, 49, & Michael, 32, born with an undiagnosed progressive neuromuscular disease. Angel Michael received his wings in 2003. Angel Jon received his wings in 2019. In 2020, Jim, their Dad, joined them.


      Welcome, Runner419!

      I'm sorry I don't know enough about aneurysms to be very helpful but I have known a number of people who had aneurysms but were told they were of no concern because they weren't likely to cause any problem.

      You don't mention having any symptoms. I agree with Rose that another opinion would be useful. Or you could just decide to ignore the aneurysm that might not be there and worry about it only if you're having troublesome symptoms indicating that something is wrong.

      If you've already been having symptoms, I think another opinion is definitely the way to go.
      SPMS diagnosed 1980. Avonex 2001-2004. Copaxone 2006-2009. Glatiramer acetate since December 2020.