The Reoccurence of an Aneurysm

Everyday The Joe Niekro Foundation receives emails with medical questions from patients who are seeking some guidance.  I wanted to share with you a recent email we received and our response from our superior medical advisory board, as I know it will be useful to many of you.

Question: What is the reoccurrence percentage of an aneurysm and what symptoms should I
be worried about and seek treatment for? I still get bad headaches and neck pain and was told it was just a migrane.   It really worries me.  Please give me some advice on what to do.

Answer: The occurrence percentage depends on clipping vs coiling. Clipping recurrence is null (hate to say zero, but once you are clipped, the aneurysm is gone).  Coiling is different. You don’t ever have a ‘reoccurence’, but the coils could migrate toward the upper part of the top of the aneurysm, and there might be a small residual down by the neck.  If you had coiling, the Endovascular team follows patients consistently with MRI follow up and they would be able to tell if this is happening.

Re: Neck/heaches.  Very common!  Hate to say that, but it is!  You are not going crazy, it is a real pain. Lots of the post op migraine/headache pain that people tend to get is #1 if you had surgery and a clipping, it is usually nerve pain at and around the incision site. Medications like Topamax is a great medication for nerve pain.  If you just got clipped or coiled, another reason for headache/neck pain is the flow of blood is rerouting itself. It used to be able to sneak in and out of the aneurysm.  Now that “highway” is blocked off with a clip or with coils, so the blood needs to reroute its direction and that causes headache pain.  The third issue is whether or not you have experienced a hemorrhage vs. elective treatment. ALWAYS, ALWAYS, ALWAYS, a patient who has had a hemorrhage, will get headaches/pain secondary to the blood in the brain irritating the outside walls of the other vessels in the brain.

Headaches/neck pain can last a long time in some cases.  We would definitely recommend seeing a neurologist who specializes in headache/migraine/nerve pain. There are different types of medications besides Tylenol that can help you.  Obviously, I do not know the specifics about
your case directly, but my answers are for the average aneursym clipping/coiled cases.

Symptoms you should be concerned about…is a “THUNDERBOLT LIGHTENING CLAPPING HEADACHE”.  One that brings you to your knees.  That would indicate a bleed.  But again, if you had intervention on your aneurysm, you are protected from a hemorrhage.

If you have questions, please feel free to email them to info@joeniekrofoundation.org and we will do our best to get them answered as quickly as possible.

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