Because most people who have an aneurysm don’t experience any noticeable symptoms, they can live for years with the aneurysm undetected and without any other health problems.
But once the aneurysm expands and puts pressure on neighboring nerves and tissues, it can cause pain, numbness, or other symptoms.
More severe (and even life-threatening) symptoms occur when an aneurysm leaks or ruptures.
The specific symptoms of aneurysms depend on the type of aneurysm, its location, and whether it’s affecting other organs or structures in the body. Because most aneurysms can be successfully treated, knowing the signs and symptoms can save your life.
The Common General Signs of an Aneurysm to Watch Out For
Most aneurysms occur in the brain or in the aorta (the main blood vessel in the body). When an aortic aneurysm is located in the chest, it is called a thoracic aortic aneurysm. When it is located in the abdomen, it is called an abdominal aortic aneurysm.
Between 1 and 5 percent of adults develop brain aneurysms, but only about 1 percent of aneurysms each year will rupture and cause problems. (1)
According to a study, 7 percent of people between ages 35 and 75 have brain aneurysms that are undetected and have not ruptured. (1)
Unruptured brain aneurysms are usually small (less than 10 milliliters in diameter) and typically do not cause symptoms.
But large, unruptured brain aneurysms can press on the brain or nerves from the brain, producing symptoms. (2)
If you experience any of these symptoms, see your doctor immediately:
- A localized headache
- Unilateral/asymmetric pupils
- Blurred or double vision
- Pain above and behind the eye
- Weakness and numbness
- Difficulty speaking
When a brain aneurysm ruptures, it usually leads to a subarachnoid hemorrhage (SAH), which causes blood to escape into the space around the brain and creates sudden symptoms.
The classic symptom of a ruptured brain aneurysm is “the worst headache ever,” which comes on suddenly, and is severe and unrelenting.
Other symptoms can include: (2)
- Nausea and vomiting
- Light sensitivity
- Sudden vision changes, including blurring, double vision, and vision loss
- Sudden pain above and behind the eye
- Sudden change in mental awareness
- Sudden trouble walking or dizziness
- Stiff neck
- Drooping of the eyelid or one side of the face
- Numbness, tingling, weakness, or paralysis in the face or limbs
- Difficulty swallowing or speaking
- Loss of consciousness
- Unilateral/asymmetric dilated pupils
- Weakness and numbness
What Are the Possible Signs and Symptoms of a Thoracic Aortic Aneurysm?
Thoracic aortic aneurysms that occur in the chest typically form and expand slowly over time, and they rarely cause symptoms. (3)
But if a thoracic aortic aneurysm grows larger, it can compress nearby tissues and cause hoarseness in the throat and difficulty swallowing. Although rare, a thoracic aortic aneurysm can also cause pain, usually a tearing or sharp pain between the shoulder blades. This usually occurs when an aneurysm grows quickly or ruptures, or if a tear develops in the aorta wall. (3)
Symptoms of a bleeding or burst aneurysm in the chest include:
- Severe throbbing or sharp stabbing pain in the chest or back, which may move into the neck, jaw, and arms
- Trouble breathing or shortness of breath
- Difficulty swallowing, speaking, or moving one side of the body
- Drop in blood pressure
What Are the Possible Signs and Symptoms of an Abdominal Aortic Aneurysm?
Is It Cardiac Arrest or a Heart Attack?
Abdominal aortic aneurysms, which develop in the part of the aorta located in the abdomen, typically do not have any symptoms unless they expand and rupture. But some people with an abdominal aortic aneurysm may notice severe and persistent pain in their back, abdomen, or groin. (4)
Other symptoms include:
- A feeling of fullness shortly after eating
- Nausea or vomiting
- Leg pain due to a blood clot
- Pain or cramping in the lower leg
- Problems with urination
- Discoloration or bluish, blood-colored spots on the feet and toes
Symptoms of a bleeding or burst abdominal aortic aneurysm can vary, but the most common symptom is pain in the back and the abdomen, and an odd pulsing sensation in the abdomen. (4)
Other symptoms include:
- Sudden, severe pain in the abdomen or lower back, often described as stabbing or ripping in nature; may spread to the groin, buttocks, and legs
- Rapid heart rate
- Clamminess or sweatiness
- Nausea, vomiting, or dizziness
- Low blood pressure
How Signs and Symptoms Can Look Different in Men and Women
Since research has historically looked at the symptoms men experience, aneurysms in women can be difficult to identify because their symptoms may not be so-called “classic” and they may not have the same symptoms men do, according to Kimberly Brown, MD, MPH, an emergency physician in Memphis. “I think it has put women at a disadvantage,” she says.
For example, women with abdominal aortic aneurysms may have vague abdominal pain and those with brain aneurysms may have a dull, persistent headache.
How Are Aneurysms Typically Screened For?
The U.S. Preventive Services Task Force recommends men between ages 65 and 75 who have ever smoked receive a one-time ultrasound screening for abdominal aortic aneurysms. For men between ages 65 and 75 who have never smoked, the recommendation is that clinicians selectively, not routinely, conduct screenings. (5)
For women, there isn’t enough evidence to recommend screening for those between 65 and 75 who have smoked and it’s not recommended for those who have never smoked. (5)
Smoking Plus High Cholesterol Ups Heart Attack Risk
Although screening recommendations for brain aneurysms can vary depending in large part on your health insurance provider, having two close relatives who experienced a brain aneurysm rupture may signal a family predisposition, so screening is recommended for first-degree relatives of anyone who has had a brain aneurysm, says George P. Teitelbaum, MD, an interventional neuroradiologist at the Pacific Neuroscience Institute in Santa Monica, California.
How Exactly Are Aneurysms Usually Diagnosed?
There are several screening and diagnostic tools doctors use to detect aneurysms. Here’s a detailed look:
Computerized Tomography Scan
Doctors discover many aortic aneurysms after administering a computerized tomography (CT) scan for some other reason. (6)
A CT scan is a painless test that uses contrast dye injected into a vein in the arm and X-rays to get clear pictures of the aorta or brain. (7)
A small brain bleed, known as a sentinel hemorrhage, may not be detected on a CT scan, so if it’s suspected, the doctor may perform a spinal tap. But a CT scan will pick up a large brain bleed, known as a subarachnoid hemorrhage, Dr. Teitelbaum says.
Between 3 and 14 days after a brain hemorrhage, the blood vessels can start to spasm (vasospasm), which affects up to 70 percent of people with a subarachnoid hemorrhage. (8) A CT scan can help doctors predict if the patient is likely to have a vasospasm.
What Are the Radiation Risks of Your Imaging Test?
Although it’s not entirely understood what causes it, one theory is that hemoglobin acts as a trap for nitric oxide from the blood vessel wall, which prevents the blood vessels from dilating and causes spasms, Teitelbaum says. A vasospasm can lead to a neurologic deficit, a type of early stroke, or seizures.
Once a brain aneurysm is detected, an ultrasound will be performed each day to look at the rate, or velocity, of blood flow in the blood vessels. If the velocity increases more than a mean 100 centimeters per second, the blood vessels can narrow. “It’s important to obtain this test every morning to get an idea of what the trend is,” Teitelbaum says.
Computed Tomography (CT) Angiography
CT angiography (angiogram) is a diagnostic screening tool that uses contrast dye and radiation to look at blood vessels and arteries. A CT angiogram may be performed if a CT scan is unable to detect a brain aneurysm that is suspected, Dr. Brown says.
“For both an abdominal and a thoracic aortic aneurysm, a CT angiogram is very useful in giving precise information about what other branches it involves, more precise measurement of its extent and diameter, and also whether the aneurysm has a clot within it,” Teitelbaum says.
An ultrasound is a painless, noninvasive screening tool that uses a wand and sound waves to look at the inside of the body to detect an abdominal aneurysm. Abdominal aortic aneurysms are the easiest type to identify and follow, Brown says.
If an aneurysm smaller than 5.5 centimeters in diameter is found, it should be followed for 6 to 12 months to make sure it doesn’t grow, Teitelbaum says.
Magnetic Resonance Imaging (MRI)
An MRI, which uses magnets and radio waves to create photos of the organs and internal structures (7), may be used to gather additional information about the size, shape, and content of a brain aneurysm, such as a blood clot. (8)