Methodist’s Dr. DeNardo Explains…When Is A Headache Really A Brain Aneurysm?
February 12, 2018
Most of the time, unruptured aneurysms exist with no symptoms. Rarely, people will experience warning signs, such as nausea, vomiting, dizziness, sensitivity to light, stiff neck and headache.
When an aneurysm is rupturing, there is often no mistaking it, says Andrew DeNardo, M.D., an interventional neuroradiologist at IU Health Methodist Hospital.
“If a person comes into an emergency room and they say, ‘I just had the worst headache of my life and it came on quickly and it felt like somebody hit me in the back of the head with a two-by-four,’ you better be looking for an aneurysm,” Dr. DeNardo says. “And that’s a person that automatically gets a head CT. You’re looking for blood.”
What: A weakness in the blood vessel of the brain that bulges and fills with blood.
Cause: High blood pressure, plaque build up in artery wall, trauma, heredity, abnormal blood flow where arteries meet.
Occurrence: 1 to 2 percent of the population.
Demographic: “There is a peak incidence in the fifth decade of life so in your 40s and 50s,” Dr. DeNardo says. “We see some people in their 30s. The youngest patient I’ve ever treated for a ruptured aneurysm is 2. So it’s not unheard of in young children.”
Dangers: In rare cases, the aneurysm ruptures and bleeds into the skull, causing stroke. “If an aneurysm bleeds so much that it increases the pressure in your head high enough and it stops the blood flow to the brain,” he says, “you probably will die or, worse, be vegetative.”
Most often: “The aneurysm leaks from a spot. A clot goes up around it and the pressure in the head gets high enough just to stop it for a moment,” Dr. DeNardo says. “For most people, the pressure goes up transiently, the bleeding stops, the clot sits on top of the aneurysm.”
When to get tested: If you have two immediate family members who have had an aneurysm you should be screened, he says.
The science: “The normal pressure inside your head is 10 to 20 centimeters of water. When an aneurysm ruptures, it might go up to 90 centimeters of water,” Dr. DeNardo says. “Then, it supersedes your ability to pump blood. That goes on long enough, your brain is going to die.”