Recognizing and Reacting to Cerebral Aneurysms

A cerebral aneurysm is a weakened spot in an artery in the brain. This weakness allows the vessel to balloon outward and fill with blood, possibly leading to pressure on a nerve or brain tissue near the aneurysm. Aneurysms also can leak or rupture, causing blood to spill into the surrounding tissue (hemorrhage). What causes them and how do they relate to headaches?


Brain aneurysms can occur in anyone and at any age. They are most common in adults between the ages of 30 and 60 and are more common in women than in men. Occasionally, cerebral aneurysms may be present from birth. Researchers estimate that between 3 and 5 percent of Americans may have an aneurysm in their lifetime. They are more common in people with certain diseases or conditions, especially polycystic kidney disease and arteriovenous malformations. Other inherited risk factors for developing cerebral aneurysms include:​

  • Autosomal dominant polycystic kidney disease
  • Ehlers-Danlos syndrome
  • Pseudoxanthoma elasticum
  • Hereditary hemorrhagic telangiectasia
  • Neurofibromatosis type 1
  • Alpha-1 antitrypsin deficiency
  • Coarctation of the aorta
  • Fibromuscular dysplasia
  • Pheochromocytoma
  • Klinefelter's syndrome
  • Tuberous sclerosis
  • Noonan syndrome
  • Alpha-glucosidase deficiency

Other Known Risk Factors Include:

  • Age over 40 years
  • Current cigarette smoking
  • Hypertension
  • Alcohol use
  • Cocaine use
  • Infection of a vessel wall
  • Head trauma
  • Intracranial neoplasm or neoplastic emboli


The most significant complication with cerebral aneurysms is that they may rupture, causing bleeding into the surrounding brain tissue. This bleeding prevents blood and oxygen from flowing to some areas of the brain, resulting in a stroke. Strokes can lead to potential permanent nerve damage or even death. If bleeding occurs into the space between the skull and brain (subarachnoid hemorrhage), there can eventually be a buildup of fluid surrounding the brain, putting additional pressure on the brain tissue.

Cerebral Aneurysms and Headaches

While cerebral aneurysms are often symptomless, they can cause headaches on occasion. While not common, even an aneurysm that has not ruptured may cause headaches in some individuals. A person may notice an abrupt, severe headache, or a series of headaches different from their usual ones. In the case of a ruptured aneurysm, patients will usually experience “the worst headache of their lives.” This headache may also be accompanied by nausea and vomiting, a brief loss of consciousness, one-sided weakness or vision loss, or severe neck pain.

A Word From Verywell

In the case of a sudden, severe headache, you should call your health care provider right away. They can tell you what the best course of action would be. You will likely need an emergency evaluation to determine if you have an aneurysm that has ruptured. Because aneurysms do not usually have symptoms until a catastrophe happens, it is difficult to know exactly what to do. Focusing on reducing the risks over which you have control (smoking, diet, etc.) would be the first step.

Discussing any concerns you may have with your physician is another thing you can do to determine your risk and any appropriate testing. As with all headache symptoms, you and your healthcare provider should discuss headache warning signs so you can react appropriately.

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  1. National Institute of Neurologic Disorders and Stroke. Cerebral aneurysms fact sheet. Updated August 13, 2019.

  2. Kim ST, Brinjikji W, Kallmes DF. Prevalence of intracranial aneurysms in patients with connective tissue diseases: A retrospective study. AJNR Am J Neuroradiol. 2016;37(8):1422-6. doi:10.3174/ajnr.A4718