Most headaches are not dangerous but a few are so it is useful to know about the various headaches that can be dangerous so you can recognise the symptoms and know when to seek medical help.
One type of dangerous headache can be caused by a cerebral aneurysm.
A cerebral aneurysm occurs when a blood vessel in the brain is weakened, causing it to bulge as the blood runs through it. About 5 percent of the population develop a cerebral aneurysm at some point in their lives.
However, most of these don’t cause any symptoms or rupture.
Symptoms
If the blood vessel leaks or ruptures it can cause:
• A very sudden severe headache, often more severe than ever experienced before
• Stiff and painful neck
• Eye pain
• Double vision
• Blurred vision or loss of vision
If you have any of these symptoms and they aren’t attributable to another medical condition , you should see your doctor. Sometimes these headache symptoms are a warning sign that a rupture will occur so seeing your health care provider promptly may well avert a life-threatening emergency.
If the aneurysm has already ruptured your headache may be accompanied by nausea and vomiting and you may have additional symptoms such as:
• Drowsiness
• Confusion
• Lethargy
• Stroke symptoms, like drooping eyelids, muscle paralysis or weakness and slurred speech
• Seizures
These symptoms can represent a medical emergency, so if you or a friend or relative is affected by any symptom listed, you should call an ambulance.
Diagnosis
Doctors will perform a physical examination. Sometimes there is swelling of the optic nerve of the eye and retinal bleeding due to increased pressure in the brain. They will also assess the patient’s ability to talk, whether they have any weakness and whether they can feel touch.
An MRI or CT scan of the brain will then show if there are any aneurysms. A lumbar puncture (spinal tap) may be done as this can determine if there is any bleeding in the brain.
A test called a cerebral angiography may be done to see how the blood flows through the brain. A local anaesthetic is given and a catheter placed through the groin and through the arteries up to the neck.
A contrast dye is then added which travels through the arteries to the brain. Due to the dye, doctors can watch the blood moving through the arteries in the brain and they can see if there are any blockages.
Treatment
Treatment depends on the size and location of the aneurysm. If it is very small it may not be operated on because very small aneurysms have less chance of rupturing.
Sometimes it is not possible to operate because of the position of the aneurysm. If this is the case, the doctor may just restrict the patient’s activities and give them medicines for headaches and seizures.
If surgery is possible, it is usually done to clip the aneurysm to prevent it from bursting.
Sometimes a catheter is passed through the arteries in your groin and up to the arteries in the neck, containing a wire that coils up inside the weakened blood vessel causing a clot to seal the aneurysm. This is called endovascular repair.
Outlook
If the patient has had surgery before a rupture occurs the outlook is very good. If it has already ruptured, the prognosis is not as good.
Half of all people with ruptured aneurysms die either on the day of rupture or within three months of it. Of the half that survive, 25 percent will have permanent disability, for instance, partial paralysis, or loss of feeling.
That is why it is important to seek help. If your headache comes on very suddenly or it’s the worst you’ve ever had, don’t delay getting medical assistance.
Sources:
Aneurysm in the brain, PubMed Health. 6 February 2012. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002387
Brain aneurysm, Tests and Diagnosis, Mayo Clinic. 6 February 2012. http://www.mayoclinic.com/health/brain-aneurysm/DS00582/DSECTION=tests-and-diagnosis
Lumbar Puncture, WebMD. 6 February 2012. http://www.webmd.com/brain/lumbar-puncture
Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting.
Reviewed February 6, 2012
by Michele Blacksberg RN
Edited by Jody Smith