Brain aneurysms are serious, potentially life-threatening emergencies.
Warning signs can include intense headaches, blurred vision, and others.
An aneurysm refers to a bulge in a blood vessel in the brain. If it leaks or bursts, it can lead to bleeding known as a hemorrhagic stroke. Many brain aneurysms are fairly common and often go unnoticed
because they don’t cause symptoms or health problems, and most never rupture. But when one does, it becomes a medical emergency, and recognizing the signs can help prevent lasting brain damage or death.
Signs of a ruptured aneurysm
A sudden, intense headache (often described as the worst headache I’ve ever had)
Blurred or double vision
Confusion
One enlarged pupil
A drooping eyelid on one side
Fainting
Nausea or vomiting
Pain around one eye
Neck stiffness
Sensitivity to light
Seizures
Weakness or numbness
The worst headache I’ve ever had
Headaches are usually the earliest and most prominent symptom, according to the Brain Aneurysm Foundation. Not everyone will have every sign, but headaches, nausea, a stiff neck, blurred vision, and sensitivity to light are among the most common. If these symptoms occur, call an ambulance rather than having someone drive you to the hospital. A ruptured aneurysm is a high-pressure emergency where every second counts, and first responders may need to start life-saving care before reaching the hospital.
Signs of a ‘leaking’ aneurysm
In some cases, an aneurysm doesn’t burst all at once. Instead, it may leak small amounts of blood over several days or weeks before a full rupture occurs. This is known as a sentinel bleed. The main sign is a sudden, severe headache that persists for days, sometimes lasting up to a couple of weeks. In any case, seek immediate medical attention before a rupture happens.
What about aneurysms that haven’t ruptured?
Aneurysms form when the walls of brain arteries become thin and weakened. Some people are born with them due to congenital defects, while others may be predisposed, especially if a close family member has a history of brain aneurysms. Women and individuals over 40 are also more likely to be diagnosed with them.
Additional risk factors
Furthermore, certain health conditions increase risk, including arteriovenous malformation, autosomal dominant polycystic kidney disease, fibromuscular dysplasia, Marfan syndrome, and vascular Ehlers-Danlos syndrome, according to Cleveland Clinic. High blood pressure can also weaken artery walls over time. Smoking, excessive alcohol use, and substance use, particularly cocaine, may further contribute to this weakening.
The effects of a rupture
Bleeding from a rupture is often minimal and may last only a few seconds, but even a small leak can seriously damage or kill nearby brain cells. It can also raise pressure inside the skull, restricting blood flow and oxygen to the brain. According to the Mayo Clinic, this may quickly lead to loss of consciousness, permanent brain damage, and death.
Complications from aneurysms
Life-threatening complications can still occur even after the initial rupture has been treated. The affected blood vessel remains at risk of re-bleeding. Blood vessels around the rupture may also narrow and constrict, which can lead to an ischemic stroke and further cell damage or death.
Another possible complication is hydrocephalus, a buildup of fluid in the brain from the spinal cord. This excess fluid can damage tissue and put pressure on the brain.
Prevention
Brain aneurysms aren’t always preventable, particularly when there is a strong hereditary link involved. However, people can lower their risk through healthy lifestyle changes, according to the NHS. The two main priorities are quitting smoking and controlling high blood pressure.
This can be supported by a diet low in salt and rich in fruits and vegetables, limiting alcohol, maintaining a healthy weight, exercising regularly, and moderating caffeine intake. The positive aspect is that these steps also help prevent other conditions, including heart disease and kidney disease. As a result, those aiming to reduce aneurysm risk can gain broader health benefits as well.
On their own, aneurysms usually don’t produce symptoms. They are often small and discovered during tests for other conditions. In some cases, though, an unruptured aneurysm can grow and press on nerves in the brain. When that happens, the following signs may appear, and medical attention should be sought immediately.
Signs of an unruptured aneurysm
Blurred or double vision
Pain around one eye
One drooping eyelid
One enlarged pupil
Weakness or numbness
Changes in headache patterns*
*Unruptured aneurysms do not usually cause ongoing headaches. However, people with chronic headaches may notice shifts in how often they occur or how severe they are. Anyone in this situation should consult a healthcare provider. That said, many unruptured aneurysms don’t require treatment, depending on the case. In all situations, it’s important to discuss concerns with a medical professional.
Genetic risk factors
