Brain Aneurysm Symptoms

Brain aneurysms occur where there is a weak spot in a brain blood vessel that fills with blood and bulges out. Left untreated, an aneurysm may rupture or burst — a very severe form of stroke. Two to three percent of people in the United States develop brain aneurysms.

The signs of brain aneurysm vary from person to person, depending on its size, growth rate and location. The experienced cerebrovascular neurosurgeons and specialists at Barnes-Jewish Hospital can identify and treat your brain aneurysm symptoms. We see hundreds of aneurysm patients every year, providing us expertise in not just diagnosis, but evaluating the cause and risk related to your aneurysm. This allows our experts to collaborate and determine the most effective treatment. 

To make an appointment with a Washington University cerebrovascular specialist at Barnes-Jewish Hospital, call 855.925.0631.

Signs of Brain Aneurysm

Most people with an unruptured brain aneurysm don’t show signs or have symptoms, while others may have symptoms because the aneurysm ruptures or because it presses on the brain or surrounding nerves.

When an aneurysm bursts, symptoms can look similar to stroke symptoms of numbness, weakness, and difficulty speaking. Other symptoms include: 

  • Sudden onset headache (often called “the worst headache of my life”)
  • Sudden onset neck pain or stiff neck
  • Sudden onset nausea and vomiting
  • Double vision
  • Loss of consciousness

If you experience any of these symptoms, call 9-1-1 immediately for emergency care. 

When an unruptured aneurysm causes symptoms, the following can develop:

  • Numbness
  • Weakness or paralysis of the face, arm or leg
  • Drooping eyelid
  • Dilated (enlarged) pupil
  • Decreased vision or double vision
  • Pain above and behind the eye
  • Severe localized headache

If you experience any of these symptoms, you should call your doctor or be seen in an emergency room for care.

What Causes an Aneurysm?

The arteries that connect at the base of the brain sometimes develop weak spots in the walls of the artery. The weak spots can enlarge and fill with blood (pouches that become aneurysms) due to the pressure in the blood flow. 

Artery weak spots can be caused by:

  • Birth defects in the artery wall
  • Smoking
  • High blood pressure
  • Arteriosclerosis (substances such as cholesterol or blood platelets collect on the artery wall)

Risk Factors for Aneurysm

Many factors can increase your risk for developing a brain aneurysm. They include:

  • Smoking
  • Older age (usually over 55 years of age)
  • Uncontrolled blood pressure
  • Drug use
  • Family history of brain aneurysms
  • Polycystic kidney disease
  • Marfan’s syndrome
  • Arteriovenous (artery or venous) malformations (AVMs)
  • Certain infections

Risk factors that increase the chance that an aneurysm will rupture include: 

  • Large aneurysm size
  • Irregular aneurysm appearance
  • History of rupture of another brain aneurysm
  • Active tobacco smoking
  • Uncontrolled blood pressure
  • Use of stimulant drugs
  • Heavy alcohol use
  • Family history of brain aneurysms

Sometimes patients with a history of brain aneurysms will develop a new aneurysm over time. Five to ten percent of all people who experience an aneurysm will develop another aneurysm in their lifetime.

If you are at risk for aneurysm, the neurosurgeons at Barnes-Jewish Hospital can use imaging tests, such as CT angiogram or MRA angiogram, to identify an aneurysm before it ruptures. If two family members have been diagnosed with a brain aneurysm, you should consider being screened for a brain aneurysm. There might be a genetic relationship. Then, our team can evaluate the risk of your aneurysm and discuss treatment options.

Possible Complications with Aneurysm Rupture

Patients with a ruptured brain aneurysm are also at risk for complications, including hydrocephalus and cerebral vasospasm.

Hydrocephalus is a buildup of cerebrospinal fluid that puts pressure on the brain. It is typically treated with a ventriculostomy — a bedside procedure in which a small tube is used to drain excess cerebrospinal fluid. Some patients need a permanent drainage tube called a shunt. 

Cerebral vasospasm is an abnormal narrowing of brain blood vessels. It can reduce blood flow to the brain and cause a stroke. This condition is treated with medications and sometimes with procedures to open up the narrowed blood vessel.

Barnes-Jewish Hospital offers several treatments that can help reduce the effects and complications following ruptured aneurysms:

  • Medications to ease the severe headache symptoms
  • Medications called “calcium channel blockers” to reduce the chance of vasospasm
  • Medications called “vasopressors” to increase your blood pressure to prevent stroke from vasospasm
  • Anti-seizure medications to prevent seizures
  • A ventricular catheter to treat hydrocephalus and ease pressure on the brain
  • Rehabilitation therapy

To make an appointment with a Washington University cerebrovascular specialist at Barnes-Jewish Hospital, call 855.925.0631.

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