DEAR DR ROACH: I am a 67-year-old healthy, active woman. Recently, I was in the hospital for a case of transient global amnesia that was diagnosed as a fluke phenomenon. Nonetheless, in an MRI, it was discovered that I have a 3-mm aneurysm on the anterior communicating artery. The neuro team has suggested watching it with scans, starting at six months. I am on baby aspirin, 40 mg of Lipitor and 25 mg of metoprolol. I’m having a very hard time adjusting to this. I think about it constantly. I have lost my appetite and am worried about everything. I’m wondering what I can do. (Hoping not to worry to death.) — T.W.
ANSWER: An arterial aneurysm is a weakening in the wall of an artery, leading the artery to swell like a balloon, which can eventually lead to rupture of the blood vessel. In the brain, this is likely to result in a stroke, sometimes a severe stroke, so I completely understand why you are worried.
However, you don’t need to be so worried. Most aneurysms like these that are discovered incidentally are never destined to rupture. It is likely that even without treatment, this will never bother you, and if they hadn’t done that MRI scan, you would have continued to enjoy good health.
About 3% of the population has an aneurysm, but only 0.5% of people will die from one. Size is the major risk factor. Below 7 mm, they are very unlikely to rupture. Between 7 and 12 mm, the risk of rupture is about 2.6% in five years. As the aneurysm gets bigger, the risk of rupture increases.
I think checking on the size in six months is a good idea. If it hasn’t grown, most experts recommend a yearly test for a few years, and then every two to five years after that.
