If it’s the worst headache of your life and it’s sudden, it may be a brain aneurysm

Amy Paquette

Amy Paquette was doing an exercise video with a friend when all of a sudden she felt dizzy and nauseous, had blurred vision and a headache — a bad, bad headache. After a night of agony, she went to the emergency room. “They said I was just dizzy and sent me home,” she says. “I called my own doctor, who sent me for a CT scan that came back normal, but the headache and other symptoms wouldn’t go away.”

After two weeks of daily headaches she called her doctor again, told her she’d been researching her symptoms and thought she had an aneurysm.

Her doctor sent her to a neurologist and an MRI (magnetic resonance imaging) along with an MRA (magnetic resonance angiography) proved Amy right. Within the next week she was in the operating room having brain surgery — a craniotomy and aneurysm clipping procedure, which prevents future bleeding and protects nearby brain tissue from further damage.

What is a brain aneurysm?

A brain aneurysm is a weak bulging spot on the wall of an artery in the brain. Picture a weak spot on a balloon or an inner tube. In the United States, one in 50 people have a brain aneurysm. Most are very small and don’t cause any symptoms. Some might be discovered by chance when a person has a test for another reason. Others can grow big enough to press on nerves in the brain and may cause double vision, drooping eyelids or pain behind the eye.

Aneurysms are most likely to cause symptoms when they rupture and blood leaks out of the artery into the spinal fluid surrounding the brain. When a rupture happens, it usually causes a sudden severe headache that people often describe as “the worst headache of my life. “Ruptures happen in about eight out of 100,000 people a year.

Brain aneurysm warning signs and symptoms

Unruptured

  • Localized headache
  • Dilated pupils
  • Blurred or double vision
  • Pain above and behind eye
  • Weakness and numbness
  • Difficulty speaking

Ruptured

  • Sudden severe headache, the worst of your life
  • Loss of consciousness
  • Nausea/vomiting
  • Stiff neck
  • Sudden blurred or double vision
  • Sudden pain above/behind the eye or difficulty seeing
  • Sudden change in mental status/awareness
  • Sudden trouble walking or dizziness
  • Sudden weakness and numbness
  • Sensitivity to light
  • Seizure
  • Drooping eyelid

If you are experiencing any or all of the symptoms of a ruptured aneurysm get medical attention immediately.

A ruptured brain aneurysm is fatal in about 40 percent of cases. Of the people who survive, roughly 66 percent will suffer some permanent deficit. For Amy, the year and a half since her surgery hasn’t been easy as she fights to get some semblance of her old life back. She hasn’t been able to return to her job as a third grade teacher yet, but hopes to soon. “I am still having daily fatigue and headaches, some still severe,” she explains. “I am not able to do any of the activities I used to enjoy — snowboarding, wakeboarding (big on action sports!), hiking, biking, swimming – at the level I used to enjoy them and many not at all. They induce immediate, severe symptoms — a headache that feels as if there is a vice around the front of my head.”

Amy attends a weekly neurorehabilitation clinic in the hopes it will ease her symptoms. She also belongs to the Maine Brain Aneurysm Support Group, which meets monthly at Maine Medical Center in Portland. “It really is great to be around people who understand what it’s like to go through this process of recovery,” she says. “It is really difficult for people who personally haven’t been through this or had a loved one go through it, to possibly understand what it is like. They see people in recovery on the ‘outside’ looking somewhat normal, but can’t always see the incredible physical and emotional pain that is going on on the inside. Most people have no idea.”

The purpose of the support group is to provide information, education, encouragement and understanding to anyone who has been affected by a brain aneurysm. The group is sponsored by Maine Medical Partners|Neurosurgery  & Spine and KAT-Walk & Karo-5 K. The walk and 5K  is an annual event in memory of two young Maine women who died of brain aneurysms. Money raised goes to the Brain Aneurysm Foundation to help fund research.

Can a brain aneurysm be prevented?

Unfortunately, there are no known ways of preventing an aneurysm from developing. According to the Brain Aneurysm Foundation, there are several risk factors:

  • Smoking
  • High blood pressure or hypertension
  • Congenital resulting from inborn abnormality in artery wall
  • Family history of brain aneurysms
  • Age over 40
  • Gender, women compared with men have an increased incidence of aneurysms at a ratio of 3:2
  • Other disorders: Ehlers-Danlos Syndrome, Polycystic Kidney Disease, Marfan Syndrome, and Fibromuscular Dysplasia(FMD)
  • Presence of an arteriovenous malformation (AVM)
  • Drug use, particularly cocaine
  • Infection
  • Tumors
  • Traumatic head injury

If you’ve been diagnosed with a brain aneurysm, it’s important to control high blood pressure, stop smoking and avoid using cocaine or other stimulant drugs. You should also talk to your doctor about the benefits and risks of taking aspirin or other drugs that thin the blood and if you’re a woman, whether or not it’s ok to be on oral contraceptives.

Getting an accurate early diagnosis is critical, but it’s clear from Amy’s experience that even some health care providers need to become more aware of symptoms and risk factors associated with a brain aneurysm. Her advice: “Do your own research. Advocate for yourself within the medical community. You know your body, listen to it and don’t stop getting the help and care you need.”

If you would like to learn more about brain aneurysms, visit the Brain Aneurysm Foundation website. If you’re interested in attending the support group in Portland or want information about the upcoming KAT-Walk & Karo-5K, go to the Maine Brain Aneurysm Awareness website or Facebook page.

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Diane Atwood

About Diane Atwood

For more than 20 years, Diane Atwood was the health reporter on News Center 6. She's now a regular guest on the Morning Report. Before she became a health reporter, Diane was a radiation therapist/dosimetrist at Maine Medical Center. In 2000, she left the world of reporting to manage marketing and public relations for Mercy Hospital. In 2011, she decided to pursue a longtime dream of being a freelance writer and launched her award-winning blog Catching Health with Diane Atwood.