Robert Wood Johnson University Hospital
New Brunswick • Somerset

What are the Symptoms of a Brain Aneurysm?

Seek medical attention immediately if you are experiencing some or all of the symptoms listed under warning signs/s ymptoms.

The presence of a brain aneurysm may not be known until the time of rupture. However, occasionally there may be symptoms that occur prior to an actual rupture due to a small amount of blood that may leak, called "sentinel hemorrhage" into the brain. Some aneurysms are symptomatic because they press on adjacent structures, such as nerves to the eye. They can cause visual loss or diminished eye movements, even if the aneurysm has not ruptured.

The symptoms of an unruptured brain aneurysm include, but are not limited to, the following:

  • Headaches (rare, if unruptured)
  • Eye pain
  • Vision deficits (problems with seeing)
  • Eye movement deficits

The first evidence of a brain aneurysm is most frequently a subarachnoid hemorrhage (SAH), due to rupture of the aneurysm. Symptoms that may occur at the time of SAH include, but are not limited to, the following:

  • Initial sign (rapid onset of "worst headache of my life")
  • Stiff neck
  • Nausea and vomiting
  • Changes in mental status, such as drowsiness
  • Pain in specific areas, such as the eyes
  • Dilated pupils
  • Loss of consciousness
  • Hypertension (high blood pressure)
  • Motor deficits (loss of balance or coordination)
  • Photophobia (sensitivity to light)
  • Back or leg pain
  • Cranial nerve deficits (problems with certain functions of the eyes, nose, tongue, and/or ears that are controlled by one or more of the 12 cranial nerves)
  • Coma and death

The symptoms of a brain aneurysm may resemble other problems or medical conditions. Always consult your doctor for a diagnosis.

How is a Brain Aneurysm Diagnosed?

A brain aneurysm is often discovered after it has ruptured or by chance during diagnostic examinations such as computed tomography (CT scan), magnetic resonance imaging (MRI), or CT angiography that are being done for other reasons.

In addition to a complete medical history and physical examination, diagnostic procedures for a brain aneurysm may include:

  • Diagnostic cerebral angiogram/digital subtraction angiography (DSA). Provides an image of the blood vessels in the brain to detect a problem with vessels and blood flow. The procedure involves inserting a catheter (a small, thin tube) into an artery in the leg and passing it up to the blood vessels in the brain. Contrast dye is injected through the catheter and X-ray images are taken of the blood vessels.
  • Computed tomography scan (CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays, and may be used to detect abnormalities and help identify the location or type of stroke. A CT angiogram (CTA) can also be obtained on a CT scan to look at the vessels.
  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. An MRI uses magnetic fields to detect small changes in brain tissue that help to locate and diagnose a stroke.
  • Magnetic resonance angiography (MRA). A noninvasive diagnostic procedure that uses a combination of magnetic resonance technology (MRI) and intravenous (IV) contrast dye to visualize blood vessels. Contrast dye causes blood vessels to appear opaque on the MRI image, allowing the doctor to visualize the blood vessels being evaluated.
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