A brain aneurysm is a bulging or ballooning of a blood vessel in the brain. It can cause severe headaches, neurological deficits, and even death if it ruptures and causes bleeding in the brain. Here is an overview of how a brain aneurysm may feel and its associated symptoms.
Headache
One of the most common symptoms of a brain aneurysm is a sudden and severe headache. This is often described as the “worst headache of your life” by those who experience it. The pain is usually intense and comes on abruptly, seeming to come out of nowhere. It may feel like a thunderclap headache or feel explosive in nature.
The headache pain from an aneurysm is often focused in one area, such as behind one eye or on one side of the head. The location depends on where the aneurysm is located in the brain. For example, an aneurysm in the front part of the brain may cause frontal headache pain.
The headache may come in waves, building up to an intense, peak level and then slightly improving before building up again. It is unlike a typical headache that slowly crescendos. The pain is generally a 10/10 in severity.
Even slight head movement may intensify the pain. Associated symptoms like nausea, vomiting, dizziness, and sensitivity to light often accompany the headache.
Neurological Symptoms
In addition to headache, an unruptured brain aneurysm may cause various neurological symptoms such as:
- Numbness or weakness on one side of the body
- Vision changes like double vision
- Balance problems or dizziness
- Confusion
- Memory loss
- Seizures
These symptoms occur because the aneurysm bulge puts pressure on surrounding nerves and brain tissue. For example, if the aneurysm presses on the optic nerve, it can cause visual changes.
Ruptured Aneurysm Symptoms
The symptoms of a ruptured brain aneurysm tend to be sudden and severe. They may include:
- Sudden, extremely severe headache
- Nausea and vomiting
- Stiff neck
- Blurred or double vision
- Sensitivity to light
- Seizures
- Loss of consciousness
- Weakness or numbness on one side of the body
When an aneurysm ruptures, there is bleeding in the brain (hemorrhage). This increases pressure inside the skull and can cause neurological deficits, coma, and death. The symptoms reflect the sudden rise in intracranial pressure and damage to brain tissue.
Ruptured aneurysms are medical emergencies requiring immediate treatment to prevent potentially fatal complications.
Location Impacts Symptoms
The location of the aneurysm in the brain impacts what symptoms it may cause. Some typical locations and related symptoms include:
Posterior Circulation Aneurysms
These occur along the vertebral or basilar arteries at the back of the brain. Symptoms may include:
- Severe headache at the back of the head that radiates to the top.
- Visual disturbances
- Vertigo, dizziness, imbalance
- Double vision
- Vomiting
- Loss of consciousness
Anterior Circulation Aneurysms
These occur along the internal carotid artery system at the front of the brain. Symptoms may include:
- Sudden, explosive frontal headache
- Weakness on one side of the body
- Speech difficulties
- Vision changes
Cavernous Sinus Aneurysms
These occur behind the eyes along the cavernous sinus. Symptoms may include:
- Headache behind or around the eyes
- Drooping eyelid
- Double vision
- Loss of vision
- Dilated pupil
Risk Factors
Certain factors increase the risk of developing a brain aneurysm. These include:
- Older age over 40
- Female gender
- High blood pressure
- Smoking
- Drug abuse, particularly stimulants like cocaine
- Heavy alcohol consumption
- Atherosclerosis
- Head trauma
- Genetic conditions like polycystic kidney disease and Ehlers-Danlos syndrome
- Family history of aneurysms
Understanding your risk factors can help determine if screening for aneurysms may be warranted.
When to Seek Emergency Care
Any sudden, severe headache reaching maximum intensity within seconds or minutes should be evaluated as a medical emergency. Do not wait to see if it resolves on its own.
Go to the emergency room or call 911 if you experience:
- Worst headache of your life
- Thunderclap headache
- Sudden headache associated with neck pain or stiffness
- Sudden headache with vision changes, numbness, weakness, or difficulty speaking
- Sudden, excruciating head pain with nausea and vomiting
- Sudden headache causing you to lose consciousness
Rapid diagnosis and treatment are essential with symptoms of a possible ruptured aneurysm. Bleeding in the brain can quickly become catastrophic.
Diagnosing Brain Aneurysms
If a brain aneurysm is suspected, doctors may use tests like:
- CT or CAT scan – This creates cross-sectional images of the brain that can reveal bleeding and large aneurysms.
- MRI – Provides more detailed brain imaging to visualize small aneurysms and their precise location.
- Cerebral angiogram – Involves injecting dye into the arteries to visualize their structure on X-rays.
- Lumbar puncture – Looks for blood in the cerebrospinal fluid, which can indicate aneurysm rupture.
These imaging and CSF tests help determine if an aneurysm is present, whether it has ruptured, its size and location.
Treatment
Treatment options for brain aneurysms include:
- Surgical clipping – The aneurysm is closed off at its base during open brain surgery.
- Endovascular coiling – Platinum coils are inserted into the aneurysm through a catheter to seal it off.
- Flow diverters – Stents placed in the artery divert blood flow away from the aneurysm.
- Medication – For unruptured aneurysms, blood pressure medication may be used to prevent rupture.
- Ruptured aneurysm – Emergency surgery is done to stop bleeding and relieve pressure inside the skull.
The best treatment depends on factors like the aneurysm’s size, location, your medical history, and your preferences.
Outlook
Small, unruptured aneurysms may not cause any symptoms or require treatment beyond monitoring. Larger aneurysms have a higher risk of rupture and are generally treated proactively.
Ruptured brain aneurysms are very serious and require emergency surgery. Even with rapid treatment, they can cause permanent neurological damage or death.
Recovering from a ruptured aneurysm often involves rehabilitation to regain lost functions. Medications and lifestyle changes to control blood pressure and prevent future aneurysms are key.
With appropriate screening, detection, and treatment, many people with brain aneurysms can do well and prevent catastrophic rupture. Pay attention to new, sudden headaches – early intervention is critical.
Conclusion
Brain aneurysms can cause sudden, severe headaches, neurological symptoms, and life threatening bleeding if ruptured. Rapid diagnosis and treatment are critical. Speak to your doctor about any new, sudden, or worst headaches of your life to determine if emergency evaluation is needed.