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17 mm Anterior Inferior Cerebellar Artery Treated by Flow Diverter 10/13/22

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    17 mm Anterior Inferior Cerebellar Artery Treated by Flow Diverter 10/13/22


    17 mm Anterior Inferior Cerebellar Artery (AICA) Aneurysm Treated Endovascularly by Flow Diverter 10/13/22

    My Story
    I was diagnosed on 9/9/22 with a 17 mm aneurysm in my left Anterior Inferior Cerebellar Artery. 30 years ago, this might have been a death sentence. 15 years ago, it would have required a craniotomy. However, it was treated on 10/12/22 endovascularly using a FRED device (flow diverter). I wanted to share my story for anyone else undergoing a similar experience.

    I will be 62 in November. I am 5’ 9”. I have been fairly active all my life, with no comorbidities. I was only slightly overweight from sitting on the couch during the pandemic.

    Diagnosis
    In April, 2022, at the end of a bout of long Covid, I developed a ringing (tinnitus) in my left ear. I thought it was an ear infection. Thinking it would resolve itself, I delayed going to a doctor and in June went hiking in the Adirondack Mountains in NY, and also in late August hiked to 8,000 feet on Mount Rainier in Seattle. In August I saw two different ENT’s. The second ENT ordered an MRI which I finally had on Friday 9/9/22.

    9/10/22: News of Aneurysm
    On Saturday 9/10/22 I got an urgent call from the ENT that my MRI revealed a very large, 15 mm, aneurysm in my left Anterior Inferior Cerebellar artery, and that I should go straight to the emergency room because I was in imminent danger of a stroke.
    I spent Saturday afternoon and early evening getting a CT scan in the ER. The CT showed the same thing as the MRI.
    Besides the ringing, I had no other symptoms. So they told me to come back for an angiogram procedure next week which I did.
    The angiogram showed that my aneurysm was even bigger than the CT indicated. Now up to 17+ mm. The outer edges of my saccular aneurysm were clotted over.



    9/11/ -10/12: Gathering information, Angiogram Results, Second Opinions
    Unlike some others on the forum, my aneurysm was so large that everyone thought it should be operated on right away. There was no real option to “wait and see.” Technically, would call my aneurysm “saccular” and “fusiform.” But to me it looked like a giant testicle, or an octopus’ floppy head. It was not just a “swelling” or bulge in an artery, it was like another organ growing in my skull. Even I, with one glance at my angiogram, thought I needed to get something like that out of my head.
    Additionally, my neurosurgeon could flip through the angiogram images like a motion picture showing us very weak blood flow through the sac. It didn’t seem to me that there could be great blood flow to the distal end of the artery.

    One Month of Anxiety, Anxiety, Anxiety
    I am lucky to live in Seattle. It happens to have a world-renown endovascular surgeon. Probably several of them. However, in my surgeon’s and my initial discussion of the MRI and CT he started off with “Why don’t we just block off that artery?” And we had a discussion about what loss of brain function in the cerebellum would mean!! (Argghhh!)
    I had done some research at this point, so I asked him, “Couldn’t we put a flow diverter in there?”
    He suspected that the artery was too narrow to be able to insert a flow. However, he said the angiogram might give us more information.
    After the angiogram, my neurosurgeon came to my bedside and said that in addition to the aneurysm, the artery was a little swollen, so he thought he could, after all, get a flow diverter in there.
    To this day, I am still not sure why he led off with the “why not just cut off the blood flow?” question. Maybe it was a Socratic technique and he was going to circle back to the other options to show how good they were.