Brain Aneurysm: Could Your Migraine Be a Symptom?

A searing, blinding, severe headache. If the onset is sudden and it’s the worst headache you’ve ever had, you should seek emergency care immediately. But even if you think it’s one of your typical, debilitating migraine headaches, you should be aware that there’s a chance it could be something more life-threatening — a brain aneurysm.

September is National Brain Aneurysm Awareness Month. With 6.8 million Americans living with an unruptured brain aneurysm, the condition isn’t rare, says the Brain Aneurysm Foundation. When a brain aneurysm ruptures, however, it is fatal in about 50 percent of cases, killing approximately 500,000 people worldwide each year and leaving many survivors with some permanent neurological deficit.

Luis Felipe Tornes, M.D., a neurologist with Baptist Health Miami Neuroscience Institute

“A headache can sometimes be a warning sign of something more serious, like an aneurysm,” says Luis Felipe Tornes, M.D., a neurologist with Baptist Health Miami Neuroscience Institute.

What is an aneurysm?

A brain or cerebral aneurysm occurs when a weak spot in an artery begins to bulge and fill with blood. It can be located anywhere within the brain or on the surface of the brain and can put pressure on brain tissue and nerves. A growing aneurysm has a greater chance of rupture.

While some people are born with aneurysms, others develop them over time due to health conditions such as high blood pressure, a head injury or a connective tissue disorder like Ehlers-Danlos syndrome, which can weaken artery walls. Aneurysms are more common in women than in men and are about twice as prevalent in Blacks and Hispanics than in whites, according to the Brain Aneurysm Foundation.

Other risk factors include polycystic kidney disease, smoking and excessive alcohol use. Although people of any age can have a brain aneurysm, they are more common in those older than 40.

Robert Wicks, M.D., neurosurgeon and co-director of cerebrovascular surgery and director of the Neuroendovascular Surgery Fellowship Program at Baptist Health Miami Neuroscience Institute

“A key risk factor is family history,” says neurosurgeon Robert Wicks, M.D., who is co-director of cerebrovascular surgery and director of the Neuroendovascular Surgery Fellowship Program at Miami Neuroscience Institute. “We usually recommend an MRA (magnetic resonance angiography) study for anyone who has two or more family members who have had an aneurysm, whether it has ruptured or not.”

Aneurysm vs. migraine

Recent studies show that there may be a link between migraines and brain aneurysms, but researchers say they don’t yet understand why some people who have migraines also develop brain aneurysms. In addition, some patients with unruptured aneurysms have migraines in the weeks or months before the aneurysm bursts, leading physicians to believe that for those patients, at least, a migraine may be a symptom of an aneurysm.

Small aneurysms can be asymptomatic and are often found when patients undergo imaging tests for other conditions. Often, doctors choose to monitor those over time. But larger or leaking aneurysms can cause debilitating symptoms, many of which are nearly identical to those experienced during a migraine. How can you tell the difference?

Aneurysm symptoms

·      Typically come on suddenly and can be located anywhere in the head

·      Pain does not decrease with medication

·      Often described as the worst headache ever experienced

·      Can be accompanied with nausea, vomiting, confusion, slurred speech, loss of consciousness

·      Can also be associated with double vision or blurred vision

Migraine symptoms

·      Headache is usually located on one side of the head

·      Pain may increase with physical activity and can last days

·      May be preceded or accompanied by visual changes, including blind spots or flashing lights

·      May include nausea, vomiting, and light and sound sensitivity

“Regardless of what you think may be causing your headache, if symptoms are accompanied by weakness on one side of the body, numbness, vision loss in one eye, facial drooping or difficulty speaking, medical evaluation is warranted,” Dr. Tornes says. “It is better to err on the side of caution.”

Aneurysm treatment

Depending on the size of an aneurysm, its location and the types of symptoms it is causing, doctors will determine what type of treatment is necessary. The experts at Miami Neuroscience Institute have extremely sophisticated diagnostic and surgical tools at their fingertips and always consider minimally invasive approaches when possible.

The most common minimally invasive procedure used to treat cerebral aneurysms is endovascular coiling, where surgeons thread a tiny catheter from the groin to the aneurysm, where they place small platinum coils that stop the blood flow and prevent rupture.

Some patients may be better suited to an open procedure that involves clipping the aneurysm to cut off the blood supply. Fortunately, the doctors say treatment is very effective.

Learn more about aneurysms and their treatment at Baptist Health Miami Neuroscience Institute.