Brain Aneurysm (cont.)
What are the symptoms of brain aneurysm?
The headache associated with a leaking aneurysm is severe. Blood is very
irritating to the brain and causes significant pain. Patients may describe the
"worst headache of their life," and the healthcare provider needs to have an
appreciation of brain aneurysm as a potential cause of this type of pain. The
headache may be associated with
nausea,
vomiting, and change in vision.
A
subarachnoid hemorrhage also causes pain and stiffness of the neck.
How is brain aneurysm diagnosed?
The diagnosis of brain aneurysm begins with a high index of suspicion by
the healthcare provider. The history of the headache, an acute onset of the
worst headache of the patient's life, associated with a stiff neck and an
ill-appearing patient on physical examination, typically lead the healthcare
provider to order a CT (computerized tomography) scan of the head. This will
show a subarachnoid hemorrhage in more than 90% of cases of ruptured aneurysm.
In the few cases that are not recognized by CT, the healthcare provider may
consider performing a lumbar puncture (LP, or spinal tap) to identify blood in
the cerebrospinal fluid that runs in the subarachnoid space.
If the CT or the LP reveals the presence of blood, angiography is performed
to identify where the aneurysm is located and to plan treatment. Angiography
(angio=artery +graphy= picture) is a procedure in which a small flexible tube is
threaded into one of the brain's arteries, and dye is injected while pictures
are taken. Newer technology allows angiography to be done in association with CT
or magnetic resonance imaging (MRI).
Though the symptoms may suggest a brain aneurysm, other diagnoses may need
to be considered. Migraine headache,
meningitis, tumor, and stroke all may cause
neurologic symptoms. Based on the patient's presentation, the healthcare
provider will need to decide which tests and studies to use to establish the
correct diagnosis.
Next: What is the treatment for brain aneurysm? »
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