Signs of an aneurysm

What It Feels Like to Have a Brain Aneurysm

When and Why a Brain Aneurysm Requires Surgery

A brain aneurysm is a balloon-like bulge in a blood vessel that can potentially burst. Between 1.5 and 5 percent of people have or develop a brain aneurysm, according to the American Stroke Association.

Given the diagnosis, Mureddu and her husband, Chuck, went online to the Brain Aneurysm Foundation and found an experienced surgeon at Massachusetts General Hospital (MGH) in Boston for the operation. But it would be another month until she was wheeled into the operating room.

Her surgeon explained that when she had felt pain in her head, the aneurysm had bled. He didn’t expect it to bleed again in the next four weeks, and he needed the time to study the best way to proceed with the surgery. Mureddu’s aneurysm was considered “giant” at 3.1 centimeters. Any aneurysm over 2.5 centimeters — one inch — is termed giant, according to MGH’s Neurovascular Center. Hers also had veins going through it, which meant the surgeon wouldn’t be able to just clip it off. He would have to do two bypasses.

Although she’d had no symptoms until that day at the gym, her doctors suspected Mureddu had had the brain aneurysm for some time.

She had a history of 23 years of migraines, she says. “I would get 12 to 18 migraines a month where I would get sick. But I lived in three states during those 23 years, and no one ordered a scan of my head.”

It’s important to note, though, that the majority of headaches do not require brain scans. The causes of migraines and tension headaches are often not revealed through such tests, which are also costly and expose you to radiation.

Be Aware of These Brain Aneurysm Symptoms

You can indeed have a brain aneurysm and not know it, says Mark Bain, MD, a neurosurgeon with the Cerebrovascular Center at the Cleveland Clinic in Ohio. If the aneurysm has not ruptured, it typically causes no symptoms, according to the Brain Aneurysm Foundation.

See a doctor immediately if you have any of these symptoms, Dr. Bain says, which may mean an aneurysm is pressing on your brain or nerves:

  • Headache in one spot
  • Pain above or behind your eye
  • Dilated pupils
  • Blurry or double vision
  • Weakness and numbness
  • Slurred speech

If the aneurysm ruptures and blood spills into the space around your brain, you could have what you’d consider the worst headache of your life.

“Some patients describe it as being hit in the back of a head by a sledgehammer,” Bain says. Other symptoms include those that Mureddu experienced: nausea, vomiting, and sudden blurred or double vision, as well as a stiff neck, dizziness, sensitivity to light, and drooping eyelids. You also could have a stroke, notes the National Heart, Lung, and Blood Institute.

If the aneurysm doesn’t rupture, your doctor may recommend treatment or careful monitoring. Once it ruptures, it should be treated with either open surgery or endovascular surgery, which is done within the blood vessels.

“We’ve taken a page out of the heart doctor’s book,” Bain says. In some cases, a surgeon can thread a catheter through the femoral artery to the brain and place coils to seal off the aneurysm.

Once you’ve had a brain aneurysm, you have a 10 to 15 percent chance of having another one, according to the Brain Aneurysm Foundation, and Bain says this is more likely if you’re younger than 50. “Elderly patients typically don’t get another,” he says. In addition, if you smoke and have an aneurysm, it’s more likely to rupture, Bain says.

Successfully Recovering From an Aneurysm

Mureddu’s recovery from her surgery in April 2013, two months after the rupture, was long and arduous. She had to relearn to speak and to walk. Determined, she took a good 10 months until she was nearly back to her old self.

Today, she continues to manage the condition by eating a healthy diet and working out at the gym at least three days a week. She also makes sure that her brain is “as active as it always was,” says Mureddu, who works in finance. In her free time she plays solitaire, Scrabble, and does Sudoku to help her mind stay sharp, and she checks in with a therapist and health coach regularly.

Unruptured brain aneurysm

Overview

An aneurysm is a balloon-like bulge of an artery wall. As an aneurysm grows it puts pressure on nearby structures and may eventually rupture. Most people find out they have an unruptured aneurysm by chance during a scan for some other problem. The risk of rupture varies depending on the aneurysm location and size. Treatment options include observation, clipping, coiling, flow diversion, or bypass.

Blood supply of the brain

To understand aneurysms, it is helpful to know how blood circulates to the brain (see Anatomy of the Brain). Blood is pumped from the heart and carried to the brain by two paired arteries, the internal carotid arteries and the vertebral arteries (Fig. 1). The internal carotid arteries supply the anterior (front) areas and the vertebral arteries supply the posterior (back) areas of the brain. After passing through the skull, the right and left vertebral arteries join together to form a single basilar artery. The basilar artery and the internal carotid arteries communicate with each other in a ring at the base of the brain called the Circle of Willis.

Figure 1. The internal carotid arteries form the anterior (green) circulation and the vertebral / basilar arteries supply the posterior (red) circulation of the brain. About 80% of aneurysms arise in the anterior system; 20% form in the posterior. Most aneurysms arise on the Circle of Willis.

What is an unruptured brain aneurysm?

An aneurysm is a balloon-like bulge or weakening of an artery wall. (Similar to a balloon on the side of a garden hose.) As the bulge grows it becomes thinner and weaker. It can become so thin that the blood pressure within can cause it to leak or burst open — a life-threatening hemorrhage in the brain. The vast majority of aneurysms are silent, meaning they have no symptoms until they rupture. It is impossible to predict if and when an aneurysm may rupture, but when they do it can cause major disability and be fatal in 40% of people. On the other hand, many people die of old age with an aneurysm, but not because of it. So, not every aneurysm is at high risk of rupture.

Aneurysms usually occur on larger blood vessels at the fork where an artery branches off. Types of aneurysms include (Fig. 2):

Saccular – (most common, also called “berry”) the aneurysm bulges from one side of the artery and has a distinct neck at its base.

Fusiform – the aneurysm bulges in all directions and has no distinct neck.

Dissecting – a tear in the inner wall of the artery allows blood to split the layers and pool; often caused by a traumatic injury.

Figure 2. A saccular aneurysm arises at the weak point of the artery where it branches. Other aneurysm types include dissecting and fusiform.

Aneurysms are also classified by size:

  • Small = less than 7 millimeters in diameter
  • Medium = 7-12 millimeters
  • Large = 13-24 millimeters (size of a dime)
  • Giant = more than 25 millimeters (quarter size)

The risk of aneurysm rupture is about 1% but may be higher or lower depending on the size and location of the aneurysm. Generally, the larger the aneurysm (>12mm), the higher risk of rupture. Also, aneurysms in the posterior circulation (basilar, vertebral and posterior communicating arteries) have a higher risk of rupture.

Risk factors for rupture include smoking, high blood pressure, drug or alcohol abuse, atherosclerosis, and genetic factors (1, 2). Lifestyle changes can reduce your risk of rupture.

What are the symptoms?

Most aneurysms don’t have symptoms until they rupture. Ruptured aneurysms release blood into the spaces around the brain called a subarachnoid hemorrhage (SAH). Unruptured aneurysms rarely show symptoms until they grow large or press on the brain or nerves. Rupture usually occurs while a person is active rather than asleep. If you experience the symptoms of a SAH, call 911 immediately!

Symptoms of an unruptured aneurysm:

  • Double vision
  • Dilated pupils
  • Pain above and behind the eye
  • Newly unexplained headaches (rare)

Symptoms of a ruptured aneurysm / subarachnoid hemorrhage (SAH):

  • sudden onset of a severe headache (often described as “the worst headache of my life”)
  • nausea and vomiting
  • stiff neck
  • transient loss of vision or consciousness

What are the causes?

Studies have shown a strong link to family history (2). If an immediate family member has suffered an aneurysm, you are 4 times more likely to have one as well. The genetic link is not completely understood and studies are underway to determine if there is a pattern of inheritance. The most important inherited conditions associated with aneurysms include Ehlers-Danlos IV, Marfan’s syndrome, neurofibromatosis NF1, and polycystic kidney disease. For those with a strong family history of aneurysm in two or more blood relatives, we recommend a screening test with a CT or MR angiogram.

Who is affected?

About 2 to 3% of Americans may have or develop an aneurysm; of those, 15% have multiple aneurysms. Unruptured aneurysms are more common than ruptured (1). However, 85% of aneurysms are not diagnosed until after they bleed. Aneurysms are usually diagnosed between ages 35 to 60 and are more common in women.

How is a diagnosis made?

Most people find out they have an unruptured aneurysm by chance (incidental) during a scan for some other medical problem. If you are experiencing symptoms and your primary care doctor suspects an aneurysm, you may be referred to a neurosurgeon. The surgeon will learn as much about your symptoms, current and previous medical problems, current medications, family history, and perform a physical exam. Diagnostic tests are used to help determine the aneurysm’s location, size, type, and involvement with other structures.

  • Computed Tomography (CT) scan is a noninvasive X-ray to review the anatomical structures within the brain and to detect bleeding in or around the brain. CT angiography involves the injection of contrast into the blood stream to view the arteries of the brain.
  • Angiogram is an invasive procedure, where a catheter is inserted into an artery and passed through the blood vessels to the brain. Once the catheter is in place, a contrast dye is injected into the bloodstream and the x-ray images are taken.
  • Magnetic Resonance Angiography (MRA) scan is a noninvasive test, which uses a magnetic field and radio-frequency waves to give a detailed view of the soft tissues of your brain. An MRA involves the injection of contrast into the blood stream to examine the blood vessels, as well as the soft tissues of the brain.

What treatments are available?

Deciding how, or even if, to treat an unruptured aneurysm involves weighing the risks of rupture versus the risks of treatment. In addition to size and location of the aneurysm, your overall health and medical history must be considered. Generally, the larger the aneurysm, the higher risk of rupture. The neurosurgeon will discuss with you all the options and recommend a treatment that is best for your individual case.

Observation
Sometimes the best treatment may be to simply watch the aneurysm over time and reduce your risk of rupture. You should quit smoking, and control high blood pressure. Aneurysms that are small, unruptured, and asymptomatic may be observed with imaging scans every year until the growth or symptoms necessitate surgery. Observation may be the best option for patients with other health conditions.

Surgical clipping
Clipping is an open surgery performed under general anesthesia. An opening is cut in the skull, called a craniotomy. The brain is gently retracted so that the artery with the aneurysm may be located. A small clip is placed across the neck of the aneurysm to block the normal blood flow from entering the aneurysm (Fig. 3). The clip is made of titanium and remains on the artery permanently. Recovery time typically is four to six weeks, but symptoms may last longer.

Figure 3: A titanium clip is placed across the neck of an aneurysm so that the blood flows through the artery, but not the aneurysm.

Artery occlusion and bypass
If the aneurysm is large and inaccessible or the artery is too damaged, the surgeon may perform a bypass surgery. A craniotomy is cut to open the skull and clips are placed to completely block off (occlude) the artery and aneurysm. The blood flow is then rerouted (bypassed) around the occluded artery by inserting a vessel graft . The graft is a small artery, usually taken from your leg, which is connected above and below the blocked artery so that blood flows through the graft.

Another method is to detach a donor artery from its normal position on the scalp and connect it above the blocked artery inside the skull. This is called a STA-MCA (superficial temporal artery to middle cerebral artery) bypass. Recovery time typically is four to six weeks, but symptoms may last longer.

Endovascular coiling
In contrast to open surgery, a minimally invasive option is endovascular coiling. It is performed during an angiogram in the radiology department. During a coiling procedure, a catheter is inserted into an artery in the groin and then passed through the blood vessels to the aneurysm in the brain. The doctor guides the catheter through the bloodstream while watching an x-ray monitor. Through the catheter, the aneurysm is packed with a basket of platinum coils. The coils induce clotting (embolization), which seals off the aneurysm and prevents blood from entering (Fig. 4). Recovery time typically is two to four days. Follow-up imaging is performed periodically for 5 years to confirm the coils have not compacted and the aneurysm is not regrowing.

Figure 4. The aneurysm is packed with platinum coils. The coils induce clotting (embolization), which seals off the space and prevents blood from entering the aneurysm.

Endovascular flow diversion
If clipping or coiling would be difficult due to the shape, size, or wide neck of the aneurysm, a flow diversion stent may be used. A flow-diverter is a tightly woven mesh tube placed inside the parent artery across the aneurysm (Fig. 5). Because blood cannot easily get through the spaces of the tight mesh stent, the blood flows inside the flow-diverter and continues down the artery without going into the aneurysm. Without the pulsating blood flow, the aneurysm will eventually clot off and shrink. Recovery time typically is two to four days.

Figure 5. A flow-diverter mesh stent is placed inside the artery to reduce blood flow from entering the aneurysm. The aneurysm will eventually clot off and shrink.

Clinical trials

Clinical trials are research studies in which new treatments—drugs, diagnostics, procedures, and other therapies—are tested in people to see if they are safe and effective. Research is always being conducted to improve the standard of medical care. Information about current clinical trials, including eligibility, protocol, and locations, are found on the Web. Studies can be sponsored by the National Institutes of Health (see clinicaltrials.gov) as well as private industry and pharmaceutical companies (see www.centerwatch.com).

Should the aneurysm be treated?

Deciding how, or even if, to treat an unruptured aneurysm involves weighing the risks of rupture versus the risks of treatment. In general, surgical craniotomy carries a higher risk of brain disability in cognition and memory, especially for people over age 65. But endovascular procedures have a higher risk of aneurysm recurrence. Listed are general pros and cons to discuss with your neurosurgeon:

Observation

  • Pros
    • No risk from intervention
    • Non-invasive MRA scans confirm aneurysm size is stable
  • Cons
    • Risk of rupture variable based on size, location, age, smoking, hypertension, and family history

Surgical craniotomy (clip, bypass)

  • Pros
    • 95% lifetime guarantee won’t regrow
    • 99% lifetime guarantee won’t rupture
  • Cons
    • Risk of brain disability (memory, thinking) from craniotomy
    • Risk of seizure

Endovascular procedure (coil, flow diversion)

  • Pros
    • Lower risks of brain disability (memory, thinking) than surgery
    • 80-85% lifetime guarantee won’t regrow
    • 98% lifetime guarantee won’t rupture
  • Cons
    • Risk of regrowth due to coil compaction
    • Invasive follow-up angiograms at 6, 12 and 24 months

Recovery & prevention

Unruptured aneurysm patients recover from surgery or endovascular treatment much faster than those who suffer a SAH.

Aneurysm patients may suffer short-term and/or long-term deficits as a result of a treatment or rupture. Some of these deficits may disappear over time with healing and therapy.

Sources & links

If you have more questions, please contact Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.

Sources

  1. Wiebers DO: Unruptured intracranial aneurysms – risk of rupture and risks of surgical intervention. N Engl J Med 339:1725-33, 1998.
  2. Thompson BG: Guidelines for the management of patients with unruptured intracranial aneurysms. Stroke 46:2368-2400, 2015.
  3. Rates of delayed rebleeding from intracranial aneurysms are low after surgical and endovascular treatment. Stroke 37:1437-42, 2006

Links
Brain Aneurysm Foundation

Glossary

aneurysm: a bulge or weakening of an arterial wall.

coiling: a procedure to insert platinum coils into an aneurysm; performed during an angiogram.

craniotomy: surgical opening in the skull.

Ehlers-Danlos IV: a genetic disorder of the connective tissue in the intestines, arteries, uterus, and other hollow organs that may lead to organ or blood vessel rupture.

embolization: inserting material, coil or glue, into an aneurysm so blood can no longer flow through it.

Marfan’s syndrome: a genetic disorder in which patients develop skeletal defects in long bones, chest abnormalities, curvature of the spine, and circulatory defects.

neurofibromatosis (NF1): a genetic disorder, also called von Recklinghausen disease, in which patients develop café-au-lait spots, freckling, and multiple soft tumors under the skin and throughout the nervous system.

polycystic kidney disease: a genetic disorder in which patients develop multiple cysts on the kidneys; associated with aneurysms of blood vessels in the brain.

subarachnoid hemorrhage (SAH): bleeding in the space between the brain and skull; may cause a stroke.

updated > 1.2020
reviewed by > Andrew Ringer, MD and Craig Kilburg, MD, Mayfield Clinic, Cincinnati, Ohio

Mayfield Certified Health Info materials are written and developed by the Mayfield Clinic. We comply with the HONcode standard for trustworthy health information. This information is not intended to replace the medical advice of your health care provider.

Here’s a stat that’s sure to keep you up at night: Currently, anywhere from three to five million people in the U.S. are walking around with brain aneurysms, according to the American Stroke Association.

If you’re thinking “what the heck is a brain aneurysm?” it’s basically a blood vessel in your brain that’s on the verge of an explosion. “Put simply, it’s a weakness that starts to occur in a blood vessel inside the brain or right outside it,” says David Putrino, Ph.D., director of rehabilitation innovation at Mount Sinai Hospital in New York City. “As blood flows through this vessel in the brain, the weak point starts to bulge out like a balloon, and it looks like a berry hanging off a branch.”

Luckily, most aneurysms don’t ever rupture or cause any symptoms. But when they do, things get really serious, really fast. According to the Brain Aneurysm Foundation, about 40 percent of ruptured brain aneurysms lead to death. Others can cause severe brain damage and neurological problems if not treated immediately. “Time is the most important factor in terms of surviving and having less neurological damage from a rupture,” says Putrino.

Here are the brain aneurysm symptoms you need to know about so you can act quickly and keep yourself healthy.

The Absolute Worst Headaches Of Your Life

“Most ruptured aneurysm survivors report experiencing the worst headache of their lives,” says Putrino. “So if you experience a very sudden and intense headache, where one minute you’re fine and the next minute you’re in extreme pain, that’s often the first sign of a rupture.”

This pain occurs because most aneurysms are in the subarachnoid, or a small, enclosed space just outside the brain, and when they burst, they flood that space with blood, says Putrino. The quick change in pressure is what you feel as a skull-splitting headache coming out of nowhere. “The subarachnoid space has lots of nerve endings, so people start to experience very intense pain,” he says. This headache can be constant or ebb and flow, he says, as each rupture is different. Some may slowly leak while other are torn open all at once.

If you experience a headache unlike anything you’ve felt before, call 911 immediately, he says.

For normal pains, watch a hot doc explain how to treat a headache without drugs:

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Nausea and Vomiting

As the subarachnoid space fills with blood from a ruptured aneurysm, it starts to push the brain down to a point in your skull called the foramen magnum, where your spinal cord and brain stem originate, says Putrino. This pressures the brain stem, an area that controls digestion and breathing can result in you feeling dizzy, nauseated, and vomiting.

Of course, you can experience nausea and vomiting for a whole host of reasons, but if they occur with any of the other brain aneurysm symptoms on this list, you should go to the emergency room, he says.

Related: A Woman Had EIGHT of These Mini-Monsters Lodged in Her Brain

A Ridiculously Stiff Neck

Having a stiff, hard-to-move, and painful neck is a sign of a ruptured aneurysm, says Putrino. “There are a bunch of nerves that control neck movement located in the foramen magnum around the brain stem,” he says. “As a large amount of pressure begins to build there, these are some of the first nerves related to movement to get affected.”

And, yes, this will feel way more intense than “I slept wrong last night.” So if you experience severe neck pain, play it safe and call 911.

Facial Tingling and Drooping Features

Similarly, the cranial nerves are also located in the brain stem. And, if there’s a rupture, they can get pushed on, causing facial tingling and paralysis, says Putrino. “Look for drooping features.”

While it’s true that some stroke and brain aneurysm symptoms are similar, both conditions warrant immediate medical treatment, so get to the emergency room ASAP.

Related: 5 Body Odors You Should Never Ignore

Blurry or Double Vision

Vision can also be affected when an aneurysm starts bleeding or bursts. As pressure builds on the brain stem, the pons, or the control center for the eyes, is impacted. This can lead to blurry or double vision and sensitivity to light, he says

“If you notice these vision symptoms come on after you get a bad headache, and then maybe you get nausea, that means something is going on neurologically,” he says. Be on the lookout for escalating and combined symptoms.

Seizures

If someone experiences a seizure, it could be a sign of a ruptured aneurysm that’s escalating quickly, says Putrino. “A seizure happens when the skull is filling with blood and the brain is getting pushed on from more than one direction, and all the neurons go into distress,” he says. “When a whole bunch of areas in the brain react all at once, this causes a seizure.”

Obviously, if you or anyone else experiences a seizure (and it’s not typical, like with epilepsy) immediately call 911.

Related: 5 Signs Your Exhaustion Is A Symptom Of A Much Bigger Problem

Hearing A Loud ‘Pop’

Some survivors of aneurysm ruptures report having heard a loud noise before they felt a headache, which is thought to be the sensation of the burst happening. “I’ve heard of this, and it’s possible that people are feeling the big pressure release in a closed space in their skull,” says Putrino. “Though, it wouldn’t make much of an actual noise when it bursts, because it’s soft tissue.”

Still, he notes, this is a valid warning sign that many people share anecdotally, so if you hear a strange pop or snap in your head and then experience pain, that’s good reason to seek medical attention ASAP.

Kristin Canning Kristin Canning is the health editor at Women’s Health, where she assigns, edits and reports stories on emerging health research and technology, women’s health conditions, psychology, mental health, wellness entrepreneurs, and the intersection of health and culture for both print and digital.

Talk to your doctor about treatments. Usually you can treat these headaches with anti-inflammatory drugs, muscle relaxers, or both.

Low-pressure headache: Spontaneous intracranial hypotension (SIH) is more commonly known as a low-pressure headache. This happens when there’s a spinal fluid leak in your neck or back. The leak causes the cushion of spinal fluid around your brain to decrease.

Symptoms of SIH include intense pain in the back of your head and neck that gets worse when you stand or sit. Low-pressure headaches usually get better after you lie down for half an hour. Some people with SIH wake up with a mild headache that gets worse through the day.

See your doctor if you think you have SIH. They likely will use a series of tests and imaging studies to diagnose the condition.

Most SIH patients find that typical headache treatments don’t work. Instead, they rely on a combination of caffeine, water, and lying down.

An outpatient procedure called an epidural blood patch is a common treatment that often works. For this procedure, your doctor draws blood from your arm and injects it into your lower spine. The headache goes away almost instantly, though you may have some lower back pain for up to a week (or in rare cases, even longer).

Occipital neuralgia: This rare type of headache involves pain in the occipital nerves. These run from your spinal cord up to your scalp. When they’re injured or inflamed, you may feel pain in the back of your head or behind your ears.

People describe the pain as stabbing and severe — like a shock. It can last for a few seconds to a few minutes. Afterward, you may feel a dull ache.

Doctors aren’t sure what causes occipital neuralgia. The headache may come on when you do normal activities, such as brushing your hair or adjusting your head on your pillow. People with a whiplash injury or tumor may have it as a side effect.

Treatment generally includes warm compresses and gentle massage. Anti-inflammatory medications and muscle relaxers may help, too. If you have these headaches often, your doctor may prescribe antidepressants or antiepileptic drugs to lessen the attacks.

Many states have recently passed new laws that are meant to increase awareness of concussions, prevent multiple injuries, and provide parents, teachers, and schools with guidelines for managing concussions. For example: In the state of Massachusetts, all adults (coaches, parents) and athletes involved in high school sports or marching band must receive special training each year on how to tell if someone has a concussion and how to get help for a student who might have one. Most importantly, anyone who has symptoms of a concussion must stop playing whatever activity they were doing right away. Injured students will need to see their doctor or go to urgent care before returning to the activity and a written plan must be in place so that the student will return to physical activities and schoolwork slowly in order to promote a full recovery. Check the rules in your state that aim to lower the risk of long term brain damage caused by concussion.

What if the concussion symptoms come back?

Tell your HCP right away if your concussion symptoms come back. He/she will tell you what to do if you experience more symptoms. For example, you may be given a prescription for medicine if you have headaches. Never take anyone else’s prescription medicine.

Get medical attention if you have any of these changes/symptoms and they don’t go away:

  • A seizure
  • Headaches, dizziness, vomiting, or sleep problems (can’t/won’t wake up)
  • Changes in vision
  • Slurred speech
  • Others notice that there’s a change in your personality
  • Or if you have a very long loss of consciousness (>1 minute)

How long will it take to heal completely after a concussion?

Most people recover from a concussion in 7-10 days, but others, particularly young children, may take longer. Everyone heals at different rates. People who have suffered a concussion in the past or have a learning disability, attention deficit disorder, anxiety, or depression can also take longer to recover from a concussion. If several months have passed and you’re still not better, some doctors call it post-concussion syndrome (“after” the concussion). This does not mean that your symptoms will never go away, only that it is taking you longer than usual to get back to your normal self.

Going back to school after a concussion: Helpful Advice

It’s a good idea to talk to tell your teachers/professors and school nurse that you’ve had a concussion. They can keep an eye on you and help with adjustments in your schedule (for a couple of weeks) until you recover.

You might ask your teacher to:

  • Adjust your school schedule or have a shorter school day
  • Allow rest periods or a break during classes
  • Photocopy notes from the board or class lectures
  • Lessen the amount of class work and homework
  • Give you more time to finish assignments
  • Take tests at a later time when you’re feeling better

How can you lessen the chance of a concussion?

Your risk of suffering a concussion partly depends on the type of activities you enjoy, but even if you don’t play contact sports or skateboard there are some things you can control. The following can help prevent any type of injury, including concussion.

  • Wear a helmet (that fits well) when doing activities such as: biking, skateboarding, rollerblading, skiing, snowboarding, or playing contact sports.
  • Buckle up and wear a seatbelt any time you are in a vehicle (and avoid all drugs and alcohol because they can affect your judgement.)
  • Think before you participate in any activity that comes with big risks, especially to your head!
  • Work on building neck and core strength

Brain Aneurysm Ruptures−Know the Warning Signs and If You’re at Risk

Treatment

When doctors detect an aneurysm early−before it bursts− they may recommend monitoring and CT or MRI imaging to detect signs of growth or change. If this occurs, surgery is usually the safest and most effective treatment. Decisions regarding management of a brain aneurysm are based on the careful evaluation of the patient’s medical history and short- and long-term risks.

Whether or not a patient survives a brain aneurysm rupture depends on a number of factors−age and overall health, the location of the aneurysm, and how quickly they are properly diagnosed and undergo emergency treatment, which is essential.

MRI or CT angiography testing (brain scan) is strongly advised for anyone with immediate family members who have experienced a ruptured aneurysm. This painless testing is 90 percent effective for aneurysms of 2 millimeters and nearly 100 percent effective for aneurysms larger than 5 millimeters. If diagnosed, your medical team can properly access the most successful treatment solution for you.

Specialized Medical Care for the Nervous System

The Neuroscience Center of Central Jersey, one of the specialized treatment centers at CentraState Medical Center in Freehold, offers neurologic diagnostic, treatment and rehabilitation for injuries or medical conditions related to the brain, spine and nervous system. Treatment services include disease and pain management, neurosurgery and advanced radiation therapy for tumors in the brain. For more information, call 866-CENTRA7 (866-236-8727) or visit centrastate.com/neuroscience.

To find a neurosurgeon or neurologist, check the Physician Finder database at centrastate.com/physicians.

Insights

In 2017, the death of a North Carolina mother of four garnered national attention. She left work after telling her husband she had an “excruciating headache.”

Moments later, she died of a ruptured aneurysm.

This story happens too often, where people immediately think they have migraines when in fact they need emergency care. By understanding each condition, we can improve outcomes and save lives.

Differences between an aneurysm and a migraine

Migraines and aneurysms are very different. Migraines are more common and are a tolerable type of headache brought on by precipitating factors. Severe throbbing pain or a pulsing sensation on one side of your head are the hallmarks. They can last for hours or days. The pain can be debilitating.

Typical symptoms include nausea, vomiting and extreme sensitivity to light and sound. Known as aura, migraines have warning signs that include blind spots and flashes of light. Migraines are treated with drugs and depending on the frequency and severity, can include prevention medications.

Aneurysms are defined by an enlargement of an artery at a branch point caused by a weakened arterial wall. When they rupture, they cause a subarachnoid hemorrhage (bleeding around the brain).

This is a completely different condition than migraines. Mostly, patients are without symptoms until the aneurysm ruptures — a “thunder clap” that quickly transitions from a headache to a cataclysmic explosive event. Those suffering will complain of the “worst headache of their life.”

The family of a North Carolina mother of four is in mourning after she died of a brain aneurysm in early April, following complaints of having a bad migraine. According to People, Lee Broadway, 41, texted her husband, Eric, the morning of April 1 to tell him she needed him to come home immediately because she was having the worst headache of her life.

Lee had suffered from migraines since she was eight, but Eric says this was different—so he raced home and took her to the ER. “She was begging to have the pain go away,” he says. “As a husband, you want to protect your wife and help her, but there was nothing I could do.” Lee was diagnosed with a brain aneurysm that was ranked a Grade 2 out of 5. “One or two is what you want to have,” Eric says. “We were told she would be okay.”

The next day, doctors said they could fix the aneurysm with surgery, and they said everything looked good. “We got the thumbs-up and took a deep breath,” Eric says. “We knew she was going to be in some pain but that she’d be with us.” But while Eric was waiting for Lee in recovery, he says the doctor came out like her “hair was on fire” and said there had been a complication. After 10 hours, the doctor said she wanted to meet with the family in a conference room. “She took us all in and all I heard was, ‘There is nothing we can do for her,’” says Eric. “I ran out and lost it.” Lee had bled out and was considered brain dead, Eric says.

Brain aneurysms are ballooning blood vessels that typically develop at branch points on the arteries that supply blood to the brain, Achal Achrol, M.D., director of neurovascular surgery and neurocritical care at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. When they rupture, they can be life-threatening.

According to the Brain Aneurysm Foundation, about 30,000 people in the U.S. suffer a brain-aneurysm rupture each year, and they’re fatal in about 40 percent of cases. Of the people who survive, more than 65 percent have some sort of permanent brain deficit.

It’s not uncommon for people to confuse the symptoms of a ruptured brain aneurysm with those of a migraine. “There are a lot of overlapping symptoms,” Achrol says. But Howard A. Riina, M.D., M.P.H.I., a professor and vice chairman of neurosurgery at NYU Langone Medical Center, tells SELF that there are a few distinctions. “The typical symptom is the worst headache of your life—even in patients who have experienced migraines,” he says. “Some people describe it as being struck by lightning.”

Johanna Fifi, M.D., director of endovascular stroke at the Mount Sinai Hospital in New York, tells SELF that a headache from an aneurysm usually starts very suddenly. “Doctors call it a thunderclap headache, it does not go away completely even with migraine medications,” she says, adding that some people may also experience neck pain.

Charles C. Park, M.D., Ph.D., director of the Minimally Invasive Brain and Spine Center at Mercy Medical Center, tells SELF that the pain caused by a brain-aneurysm rupture is a pounding, sudden-onset headache that can be felt all over a person’s head. “A migraine is usually one-sided, whereas an aneurysm is on both sides and pain everywhere,” he says.

While Lee had a history of migraines, there is no evidence that having migraines puts you at a higher risk for aneurysms, Fifi says. “However, many patients with migraines get MRIs of the head, and sometimes aneurysms are incidentally discovered that way.”

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