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Headache vs. aneurysm: Recognizing the symptoms

Friday, September 22, 2023 8:33 AM

By NorthShore – Edward-Elmhurst Health

Headaches aren’t fun, regardless of the pain level.

But when a headache feels really bad, you might start to wonder if something else is going on.

“Most headaches, whether mild or moderate intensity, will ease with time and home remedies, including over-the-counter pain relievers,” said William Ares, MD, a neurosurgeon with NorthShore University HealthSystem. “But headaches associated with bleeding from a ruptured brain aneurysm can cause severe pain and have some different symptoms that set them apart from a standard headache or a migraine.”

A brain aneurysm forms when a weak or thin wall of an artery in the brain stretches out and fills with blood. The ballooning artery can put pressure on nerves or adjacent brain tissue, which can cause symptoms such as pain behind or above an eye, a dilated pupil, numbness or weakness.

Some small brain aneurysms cause no symptoms and are discovered during imaging tests for another medical issue.

“People can live with a brain aneurysm for years, but if it ruptures it can cause severe, sudden symptoms. A ruptured brain aneurysm requires immediate medical attention,” said Daniel Heiferman, MD, a neurosurgeon with Edward-Elmhurst Health. “If someone experiences any of these symptoms, they should call 911.”

When we’re hit with a bad headache and our thoughts immediately jump to worst-case scenarios, it could help to understand some of the symptoms that could indicate a ruptured brain aneurysm.

headache vs aneurysmSymptoms that may point to a brain aneurysm include:

  1. A sudden severe headache. And not just a severe headache, the worst headache you’ve ever had. They’re called “thunderclap” headaches, and typically develop quickly, going from no pain to the highest level of pain in an hour or less. Migraine headaches are also severe, but the onset is slower and migraines are accompanied by some recognizable symptoms, such as auras, or are preceded by symptoms that warn of the impending migraine.
  2. Unusual symptoms. Standard headaches can cause nausea and neck pain. But a ruptured brain aneurysm can also include symptoms such as loss of consciousness, stroke-like weakness on one side of the face or body, confusion, speech problems or even seizures.
  3. Recent bad headaches. Sometimes people have a series of painful headaches — worse than a typical headache, but not as bad as the sudden severe headache — leading up to the rupture that are caused by a smaller bleeding event in the brain. These headaches are sometimes accompanied by vision changes, seeing double or a dilated pupil.

Brain aneurysms most commonly occur in people age 35 to 60, and it’s estimated that one in 50 people have an unruptured brain aneurysm. Some people may inherit a genetic tendency for weak blood vessels.

While we can’t control our age or genetics, there are things we can do to help prevent brain aneurysms from forming. High blood pressure is the leading cause of bleeding in the brain, which is most often caused by a ruptured brain aneurysm. Talk to your physician about your blood pressure and how to keep it in a healthy, controlled range.

Other risk factors for brain aneurysms include smoking, excessive alcohol consumption, drug use, head trauma and atherosclerosis (a buildup of plaque in the arteries).


Learn more about the NorthShore Neurological Institute.

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