7 Warning Signs of Aneurysms You Should Never Ignore

An aneurysm is a bulge or ballooning in a blood vessel caused by weakness in the vessel wall. This medical condition can occur in any blood vessel throughout the body, but most commonly affects arteries in the brain, aorta, legs, and spleen. Understanding what is an aneurysm and recognizing its warning signs is crucial because if left untreated, an aneurysm can rupture, leading to life-threatening internal bleeding.

The aneurysm definition describes it as an abnormal widening or ballooning of a portion of an artery due to weakness in the blood vessel wall. While many aneurysms develop slowly over years and may never cause symptoms, others can grow rapidly and rupture suddenly. The symptoms vary significantly depending on the location, size, and whether the aneurysm has ruptured. Early detection is vital for preventing serious complications.

Here are the seven most important warning signs of aneurysms that everyone should be aware of:

1. Sudden and Severe Headache

Often described as “the worst headache of your life,” a sudden, extremely severe headache is the most common and critical warning sign of a ruptured brain aneurysm. This headache comes on suddenly without warning and differs dramatically from typical headaches or migraines.

The pain is usually described as:

• Thunderclap-like onset – reaching maximum intensity within seconds
• Excruciating and unbearable pain
• Unlike any headache experienced before
• May be accompanied by a popping or snapping sensation in the head

This symptom requires immediate emergency medical attention as it often indicates a ruptured aneurysm, which is a medical emergency. Even if the headache subsides, you should still seek immediate medical care as this could be a warning leak before a major rupture.

2. Vision Problems and Eye Pain

Aneurysms located near the optic nerves or in the brain can cause various visual disturbances. These vision changes may develop gradually or appear suddenly depending on the aneurysm’s growth rate and location.

Common visual symptoms include:

• Blurred or double vision
• Loss of peripheral vision
• Dilated pupils or pupils of unequal size
• Drooping eyelid on one side
• Pain above or behind the eye
• Sensitivity to light

These symptoms occur when an aneurysm presses against the nerves controlling eye movement and vision. If you experience sudden vision changes, especially combined with other symptoms, seek immediate medical evaluation.

3. Neck Pain and Stiffness

A stiff neck, particularly when accompanied by other neurological symptoms, can indicate a brain aneurysm or a rupture that has caused bleeding into the space surrounding the brain (subarachnoid hemorrhage).

This symptom typically presents as:

• Severe neck stiffness making it difficult to touch chin to chest
• Pain that radiates from the head down to the neck and shoulders
• Muscle rigidity in the neck region
• Pain that worsens with movement

Neck stiffness combined with sudden severe headache is a classic sign of subarachnoid hemorrhage and requires immediate emergency care. The stiffness occurs because blood irritates the membranes covering the brain and spinal cord.

4. Seizures and Loss of Consciousness

When an aneurysm ruptures or grows large enough to affect brain tissue, it can trigger seizures or cause a person to lose consciousness. These are serious neurological symptoms indicating significant brain involvement.

Related manifestations include:

• Sudden convulsions or uncontrolled shaking
• Brief or prolonged loss of consciousness
• Confusion or altered mental state
• Temporary memory loss
• Difficulty staying awake or extreme drowsiness

A seizure occurring for the first time in an adult, especially when accompanied by severe headache, should always be evaluated emergently. The seizure may result from bleeding irritating the brain tissue or from pressure the aneurysm exerts on surrounding structures.

5. Chest or Back Pain

Aneurysms in the aorta (the body’s largest artery) often cause chest or back pain. The location and quality of pain depend on where along the aorta the aneurysm has formed. An aortic aneurysm can occur in the chest (thoracic aortic aneurysm) or abdomen (abdominal aortic aneurysm).

Pain characteristics include:

• Deep, constant aching in the chest or upper back
• Sharp, sudden, tearing pain (especially with rupture or dissection)
• Pain that may radiate to the jaw, neck, or arms
• Sensation of something ripping or tearing inside the chest
• Pain that intensifies with deep breathing

Thoracic aortic aneurysm pain is often felt between the shoulder blades or in the chest. Sudden, severe tearing pain in the chest or back could indicate an aortic dissection or rupture – a life-threatening emergency requiring immediate surgery.

6. Abdominal Pain and Pulsating Sensation

An abdominal aortic aneurysm (AAA) may cause symptoms in the stomach area, though many remain asymptomatic until they become large or rupture. This type of aneurysm is one of the most common and potentially dangerous.

Warning signs include:

• Pulsating sensation near the navel
• Deep, constant abdominal or side pain
• Back pain that doesn’t improve with position changes
• Feeling of fullness after eating small amounts
• A pulsating mass that can be felt during physical examination

The pulsating sensation may feel like a heartbeat in the stomach. If you notice a rhythmic pulsating feeling in your abdomen, especially if you’re over 60 or have risk factors like smoking or high blood pressure, consult your doctor promptly for evaluation and possible screening.

7. Neurological Symptoms and Cognitive Changes

Brain aneurysms, whether ruptured or unruptured, can cause various neurological and cognitive symptoms depending on their size and location. These symptoms may develop gradually as an unruptured aneurysm grows or appear suddenly if rupture occurs.

Common neurological manifestations include:

• Difficulty speaking or slurred speech
• Numbness or weakness on one side of the body or face
• Difficulty with balance and coordination
• Confusion and difficulty concentrating
• Memory problems
• Nausea and vomiting
• Sensitivity to light (photophobia)
• Behavioral changes or mood swings

These symptoms occur when an aneurysm presses on brain tissue or nerves, or when bleeding from a rupture affects brain function. Any sudden neurological change should be treated as a potential emergency, especially in individuals with known risk factors for aneurysms.

Main Causes of Aneurysms

Understanding the underlying causes and risk factors for aneurysms can help with prevention and early detection. Aneurysms develop when blood vessel walls become weakened over time due to various factors:

High Blood Pressure (Hypertension): Chronic high blood pressure is the leading risk factor for aneurysms, especially aortic aneurysms. The constant force of blood pushing against weakened arterial walls causes them to bulge and balloon outward over time.

Atherosclerosis: The buildup of fatty deposits (plaques) on artery walls weakens the vessel structure and makes aneurysms more likely to form. This hardening of the arteries reduces elasticity and strength of blood vessel walls.

Genetic Factors and Family History: Having a close family member with an aneurysm increases your risk significantly. Certain genetic conditions like Marfan syndrome, Ehlers-Danlos syndrome, and polycystic kidney disease are associated with higher aneurysm risk due to inherited connective tissue abnormalities.

Smoking: Tobacco use is one of the strongest modifiable risk factors for aneurysm development. Smoking damages blood vessel walls, increases blood pressure, and accelerates atherosclerosis, significantly raising the risk of both aneurysm formation and rupture.

Age and Gender: Aneurysm risk increases with age, particularly after age 60. Brain aneurysms are more common in women, while abdominal aortic aneurysms occur more frequently in men.

Infections and Inflammation: Certain infections can weaken artery walls and lead to infectious (mycotic) aneurysms. Inflammatory conditions like vasculitis can also damage blood vessels and contribute to aneurysm formation.

Traumatic Injury: Severe trauma to the head, chest, or abdomen can damage blood vessels and lead to traumatic aneurysms, though these are less common than other types.

Drug Use: Cocaine and amphetamine use can cause sudden, severe increases in blood pressure that may trigger aneurysm formation or rupture.

Prevention Strategies

While not all aneurysms can be prevented, especially those related to genetic factors, you can significantly reduce your risk by addressing modifiable risk factors and maintaining overall cardiovascular health:

Control Blood Pressure: Managing hypertension is the single most important preventive measure. Regular monitoring and keeping blood pressure within healthy ranges (typically below 120/80 mmHg) reduces stress on arterial walls.

Quit Smoking: Stopping tobacco use is crucial for aneurysm prevention. Within years of quitting, your risk begins to decrease. Avoid secondhand smoke exposure as well.

Maintain a Heart-Healthy Diet: Follow a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit sodium, saturated fats, and cholesterol to protect blood vessel health and maintain healthy blood pressure.

Exercise Regularly: Engage in moderate physical activity for at least 150 minutes per week. Regular exercise helps control blood pressure, maintain healthy weight, and improve overall cardiovascular health.

Manage Cholesterol Levels: Keep cholesterol levels in check through diet, exercise, and medication if recommended by your healthcare provider. This helps prevent atherosclerosis that weakens artery walls.

Limit Alcohol Consumption: Excessive alcohol intake can raise blood pressure and contribute to aneurysm formation. If you drink, do so in moderation.

Manage Stress: Chronic stress can contribute to high blood pressure. Practice stress-reduction techniques like meditation, yoga, deep breathing, or other relaxation methods.

Get Screened if At Risk: If you have a family history of aneurysms, genetic conditions, or multiple risk factors, talk to your doctor about screening. Ultrasound screening for abdominal aortic aneurysms is recommended for men aged 65-75 who have ever smoked.

Manage Underlying Health Conditions: Properly control conditions like diabetes, high cholesterol, and autoimmune disorders that can affect blood vessel health.

Frequently Asked Questions

What exactly is an aneurysm?

An aneurysm is a bulge or ballooning in the wall of a blood vessel caused by weakness in the vessel wall. It can occur in any blood vessel but most commonly affects arteries, particularly in the brain, aorta, legs, and spleen. The weakened area fills with blood and expands outward, creating a balloon-like protrusion that can grow over time and potentially rupture.

Are all aneurysms dangerous?

While all aneurysms have the potential to rupture, not all are immediately life-threatening. Small, unruptured aneurysms may never cause problems and can be monitored. However, larger aneurysms and those that rupture are medical emergencies. The danger depends on size, location, growth rate, and individual risk factors. Regular monitoring by healthcare professionals is essential for known aneurysms.

Can you feel an unruptured aneurysm?

Most unruptured aneurysms cause no symptoms and cannot be felt, which is why they’re often called “silent killers.” However, larger unruptured aneurysms may cause symptoms depending on their location, such as pain, vision problems, or a pulsating sensation. Abdominal aortic aneurysms may sometimes be felt as a pulsating mass in the abdomen during physical examination.

How fast do aneurysms grow?

Growth rates vary significantly. Some aneurysms remain stable for years while others grow rapidly. On average, abdominal aortic aneurysms grow about 0.3-0.4 cm per year, but this varies based on size, location, and individual factors like smoking and blood pressure control. Brain aneurysms generally grow slowly, but growth patterns are unpredictable, which is why monitoring is important.

Who is at highest risk for aneurysms?

People at highest risk include those with high blood pressure, smokers, those over 60 years old, individuals with a family history of aneurysms, people with certain genetic conditions (Marfan syndrome, Ehlers-Danlos syndrome, polycystic kidney disease), and those with atherosclerosis. Men are at higher risk for abdominal aortic aneurysms, while women have higher rates of brain aneurysms.

Can stress cause an aneurysm to rupture?

While stress alone doesn’t typically cause an aneurysm to form, sudden severe stress or activities that cause sudden blood pressure spikes (heavy lifting, intense straining, emotional trauma) can potentially trigger rupture of an existing aneurysm. Chronic stress contributes to high blood pressure, which is a major risk factor for aneurysm formation and growth. Managing stress is important for overall cardiovascular health.

Is an aneurysm the same as a stroke?

No, but they’re related. An aneurysm is a bulging blood vessel, while a stroke is the result of interrupted blood flow to the brain. However, a ruptured brain aneurysm can cause a hemorrhagic stroke (bleeding in the brain). An aneurysm itself is a structural problem with the blood vessel, whereas a stroke is the damage that occurs when brain tissue doesn’t receive adequate blood and oxygen.

When should I go to the emergency room?

Seek immediate emergency care if you experience: sudden, severe headache unlike any before; sudden vision changes; loss of consciousness; seizures; sudden severe chest or back pain with a tearing sensation; sudden severe abdominal or back pain; sudden weakness, numbness, or difficulty speaking; or any combination of symptoms described in this article. These could indicate a ruptured aneurysm, which is a life-threatening emergency requiring immediate treatment.

References:

• Mayo Clinic – Brain Aneurysm
• American Heart Association – Aortic Aneurysm
• National Heart, Lung, and Blood Institute – Aneurysm
• National Institute of Neurological Disorders and Stroke – Cerebral Aneurysms
• Johns Hopkins Medicine – Aneurysm