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Table of Contents
Timing
Intense Headache vs. Ruptured Brain Aneurysm Headache
Diganosis
Risks
Headache After Brain Aneurysm
A brain aneurysm rupture can cause severe symptoms, such as an intense headache that comes on without warning. This type of headache quickly reaches peak pain in less than 60 seconds. It requires prompt medical care.
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Timing of Brain Aneurysm Headache
Start of a Headache Before a Rupture
The start of a headache before a rupture can occur anywhere from six to 20 days before the rupture. This “sentinel headache” is considered a warning sign of a rupture.
About 15% to 60% of people with aneurysm rupture experience a sentinel headache before rupture. It occurs as a sudden severe headache when an aneurysm starts to bleed or “leak” several days before it ruptures.
Though sentinel headaches have no official diagnostic criteria, they tend to be worse than a common headache but not as intense as the headache that occurs when the aneurysm bursts. The pain does not typically occur in a specific location.
Headache During a Rupture
The progression of a headache during an aneurysm rupture is almost immediate. This type of headache, called athunderclap headache, occurs quickly and without warning. Though a thunderclap headache can occur without a rupture, it should always be treated as a medical emergency.
A thunderclap headache usually comes on at full force, progressing from normalcy to extreme pain in less than 60 seconds. It occurs without any trigger and lasts for at least five minutes. The pain can occur anywhere in your head and may extend down the back of your neck.
The following symptoms may also occur with a thunderclap headache:
The rupture of a brain aneurysm and astrokeare very similar but not the same. An aneurysm can lead to a stroke, but the reverse is not true. Strokes occur when the blood flow to your brain is interrupted.
A ruptured aneurysm interferes with the flow of blood to your brain when it bursts. Instead of the blood flowing to your brain, the blood from the ruptured aneurysm seeps out into the spaces in your brain, causing ahemorrhagic stroke, or a bleeding stroke. These strokes are more likely to occur with uncontrolledhypertension (high blood pressure).
Headache Without a Rupture
An unruptured headache usually doesn’t cause symptoms unless it happens as a sentinel headache warning of an impending rupture. As an unruptured aneurysm grows, it can exert pressure on the nerves and tissues in your brain, causing the following symptoms:
These headaches can be chronic, resembling migraine headaches, though they should not be discounted as harmless. An aneurysm rarely disappears or heals on its own. Because a ruptured aneurysm could occur at any time, contact your healthcare provider for an evaluation if you have symptoms of a headache without rupture.
Though it can often be hard to distinguish between an intense headache, such as a migraine or a tension headache, and a ruptured brain aneurysm headache, certain differentiating characteristics can help you determine the cause of your pain.
People with aneurysmsare typically without symptoms until the aneurysm ruptures. A headache that accompanies a ruptured brain aneurysm can’t be linked with any obvious triggers. It can seem to happen out of nowhere. It quickly becomes an intense event, often in less than a minute.
Describing Pain
People who experience ruptured brain aneurysm headaches often refer to them as the worst headache of their life. They describe the pain as like getting hit on the head or like a thunderclap. In contrast, severe throbbing pain or a pulsing sensation on one side of your head tends to characterize the pain from a migraine. This pain may subside when treated with certain medications.
However, everyone’s body reacts differently to pain and trauma, so identifying the cause of a headache yourself is impossible. If you’re in doubt about your symptoms or experience a headache that is different from any you’ve had before, call 911 immediately. Do not risk delaying treatment for a possible ruptured brain aneurysm headache.
Emergency Coinciding SymptomsSymptoms of a ruptured aneurysm indicate the need for immediate medical care. Though a sudden, severe headache can indicate a ruptured aneurysm, other emergency coinciding symptoms of a ruptured aneurysm can include:ConfusionExtremefatigue, sleepiness, or stuporPtosis (eyelid drooping)NauseaVomitingMuscle weakness, numbness, or decreased sensation, or difficulty moving any part of your bodyDysarthria (also known as dysarthosis) and anarthria (problems speaking)Double vision, loss of vision, or other vision changesLight sensitivityConvulsions(seizures)Loss of consciousness orcomaIf you are alone when symptoms occur, call 911 immediately for help. Do not wait for symptoms to worsen. Loss of consciousness can occur and prevent you from reaching out for help.
Emergency Coinciding Symptoms
Symptoms of a ruptured aneurysm indicate the need for immediate medical care. Though a sudden, severe headache can indicate a ruptured aneurysm, other emergency coinciding symptoms of a ruptured aneurysm can include:ConfusionExtremefatigue, sleepiness, or stuporPtosis (eyelid drooping)NauseaVomitingMuscle weakness, numbness, or decreased sensation, or difficulty moving any part of your bodyDysarthria (also known as dysarthosis) and anarthria (problems speaking)Double vision, loss of vision, or other vision changesLight sensitivityConvulsions(seizures)Loss of consciousness orcomaIf you are alone when symptoms occur, call 911 immediately for help. Do not wait for symptoms to worsen. Loss of consciousness can occur and prevent you from reaching out for help.
Symptoms of a ruptured aneurysm indicate the need for immediate medical care. Though a sudden, severe headache can indicate a ruptured aneurysm, other emergency coinciding symptoms of a ruptured aneurysm can include:
If you are alone when symptoms occur, call 911 immediately for help. Do not wait for symptoms to worsen. Loss of consciousness can occur and prevent you from reaching out for help.
How to Confirm Brain Aneurysm With Headache
Medical imaging tests are the only reliable way to confirm a brain aneurysm with a headache. This is why most brain aneurysms remain undiagnosed until they rupture and cause symptoms. In some cases, a medical imaging test may recognize an undiagnosed brain aneurysm for another reason.
When you have brain aneurysm symptoms, getting to a hospital as soon as possible is key to your treatment because medical equipment is necessary for a diagnosis. If you have symptoms of an aneurysm one of the following brain imaging tests will help you get a diagnosis:
Risks of Brain Aneurysm Headache
Getting immediate and proper medical attention is critical due to the risks of a brain aneurysm headache. Though most brain aneurysms don’t cause symptoms, the onset of symptoms such as a severe headache can be a sign of a rupture, which quickly becomes a life-threatening event that requires immediate medical attention.
Unfortunately, a ruptured brain aneurysm can be deadly. About half of all ruptured brain aneurysms are fatal. Among fatalities, about 15% of those affected die before they reach a hospital. In most cases, death occurs when initial bleeding causes a massive and rapid brain injury.
The consequences are also severe for those who survive a ruptured brain aneurysm. About two-thirds of brain aneurysm survivors experience permanent neurological damage (even with treatment). A prompt diagnosis of a ruptured brain aneurysm is critical because the initial brain hemorrhage may be fatal or result in devastating neurological consequences.
The risks of a brain aneurysm headache include the following serious complications among survivors:
Likelihood
What to Do
Do not ignore any headache that occurs after a brain aneurysm. In people with ruptured aneurysms, rebleeding can pose serious complications. Research indicates that rebleeding occurs in 8% to 23% of people with ruptured aneurysms within the first 72 hours after onset, with a 60% fatality rate.
The following factors can increase your risk of rebleeding:
If you experience a headache after a ruptured or unruptured brain aneurysm, contact your healthcare provider immediately. If your symptoms involve a severe headache or other signs of a ruptured aneurysm, call 911 for immediate medical care.
Coping With Headaches After a Stroke
Experiencing headache symptoms after a stroke is common. These headaches are often unrelated to the location of the stroke but occur as a reaction to changes that happened in your brain during your stroke. Between 20% and 30% of stroke survivors experience headaches for the first time after having a stroke. Stroke survivors who had headaches before their stroke may have more severe headaches after their stroke.
Report headache symptoms after a stroke to your healthcare provider to determine the cause and appropriate treatment. You can often manage headaches unrelated to an aneurysm with painkillers or lifestyle modifications. Some causes of headaches after a stroke include:
Headache Triggers
Summary
A ruptured brain aneurysm can cause a sudden and intense headache. The pain from this type of headache, called a thunderclap headache, reaches peak pain in less than a minute. It lasts for at least five minutes. This type of headache is a life-threatening issue that should prompt a call to 911.
A partially ruptured, or leaking, brain aneurysm can cause sentinel headaches. These headaches can act as warning signs of a likely aneurysm rupture within about two weeks. An unruptured brain aneurysm can remain undetected unless it grows or ruptures and causes symptoms.
Medical imaging is the only way to diagnose a brain aneurysm headache. If you or a companion has a sudden and severe headache, call 911 to get prompt medical care. Doing this may save your life or help you avoid severe brain damage if you survive.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Migraine Foundation.What is a thunderclap headache?Penn Medicine.Brain aneurysm.Wan Z, Meng H, Xu N, et al.Clinical characteristics associated with sentinel headache in patients with unruptured intracranial aneurysms.Interv Neuroradiol. 2021 Aug;27(4):497-502. doi:10.1177/1591019920971977American Headache Society.Thunderclap headaches.UVA Health.Strokes vs. aneurysms: not always the same emergencies.NHS.Symptoms: brain aneurysm.Premier Health.Will my brain aneurysm burst?Northwell Health.Migraines and aneurysms: What’s the difference?National Institute of Neurological Disorders and Stroke.Cerebral aneurysms.University of Illinois Hospital and Health Sciences System.Brain aneurysm.Brigham and Women’s Hospital.Brain aneurysm.Brain Aneurysm Foundation.Statistics and facts.Huckhagel T, Klinger R, Schmidt NO, et al.The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis.Acta Neurochir.2020;162: 893–903. doi:10.1007/s00701-020-04235-7Calviere L, Gathier CS, Rafiq M, et al.Rebleeding after aneurysmal subarachnoid hemorrhage in two centers using different blood pressure management strategies.Front. Neurol.2022;13:836268. doi:10.3389/fneur.2022.836268Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: a multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019Stroke Association.Headaches after stroke.
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Migraine Foundation.What is a thunderclap headache?Penn Medicine.Brain aneurysm.Wan Z, Meng H, Xu N, et al.Clinical characteristics associated with sentinel headache in patients with unruptured intracranial aneurysms.Interv Neuroradiol. 2021 Aug;27(4):497-502. doi:10.1177/1591019920971977American Headache Society.Thunderclap headaches.UVA Health.Strokes vs. aneurysms: not always the same emergencies.NHS.Symptoms: brain aneurysm.Premier Health.Will my brain aneurysm burst?Northwell Health.Migraines and aneurysms: What’s the difference?National Institute of Neurological Disorders and Stroke.Cerebral aneurysms.University of Illinois Hospital and Health Sciences System.Brain aneurysm.Brigham and Women’s Hospital.Brain aneurysm.Brain Aneurysm Foundation.Statistics and facts.Huckhagel T, Klinger R, Schmidt NO, et al.The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis.Acta Neurochir.2020;162: 893–903. doi:10.1007/s00701-020-04235-7Calviere L, Gathier CS, Rafiq M, et al.Rebleeding after aneurysmal subarachnoid hemorrhage in two centers using different blood pressure management strategies.Front. Neurol.2022;13:836268. doi:10.3389/fneur.2022.836268Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: a multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019Stroke Association.Headaches after stroke.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Migraine Foundation.What is a thunderclap headache?Penn Medicine.Brain aneurysm.Wan Z, Meng H, Xu N, et al.Clinical characteristics associated with sentinel headache in patients with unruptured intracranial aneurysms.Interv Neuroradiol. 2021 Aug;27(4):497-502. doi:10.1177/1591019920971977American Headache Society.Thunderclap headaches.UVA Health.Strokes vs. aneurysms: not always the same emergencies.NHS.Symptoms: brain aneurysm.Premier Health.Will my brain aneurysm burst?Northwell Health.Migraines and aneurysms: What’s the difference?National Institute of Neurological Disorders and Stroke.Cerebral aneurysms.University of Illinois Hospital and Health Sciences System.Brain aneurysm.Brigham and Women’s Hospital.Brain aneurysm.Brain Aneurysm Foundation.Statistics and facts.Huckhagel T, Klinger R, Schmidt NO, et al.The burden of headache following aneurysmal subarachnoid hemorrhage: a prospective single-center cross-sectional analysis.Acta Neurochir.2020;162: 893–903. doi:10.1007/s00701-020-04235-7Calviere L, Gathier CS, Rafiq M, et al.Rebleeding after aneurysmal subarachnoid hemorrhage in two centers using different blood pressure management strategies.Front. Neurol.2022;13:836268. doi:10.3389/fneur.2022.836268Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: a multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019Stroke Association.Headaches after stroke.
American Migraine Foundation.What is a thunderclap headache?
Penn Medicine.Brain aneurysm.
Wan Z, Meng H, Xu N, et al.Clinical characteristics associated with sentinel headache in patients with unruptured intracranial aneurysms.Interv Neuroradiol. 2021 Aug;27(4):497-502. doi:10.1177/1591019920971977
American Headache Society.Thunderclap headaches.
UVA Health.Strokes vs. aneurysms: not always the same emergencies.
NHS.Symptoms: brain aneurysm.
Premier Health.Will my brain aneurysm burst?
Northwell Health.Migraines and aneurysms: What’s the difference?
National Institute of Neurological Disorders and Stroke.Cerebral aneurysms.
University of Illinois Hospital and Health Sciences System.Brain aneurysm.
Brigham and Women’s Hospital.Brain aneurysm.
Brain Aneurysm Foundation.Statistics and facts.
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Calviere L, Gathier CS, Rafiq M, et al.Rebleeding after aneurysmal subarachnoid hemorrhage in two centers using different blood pressure management strategies.Front. Neurol.2022;13:836268. doi:10.3389/fneur.2022.836268
Paolucci S, Iosa M, Toni D, et al.Prevalence and time course of post-stroke pain: a multicenter prospective hospital-based study.Pain Med. 2016;17(5):924-30. doi:10.1093/pm/pnv019
Stroke Association.Headaches after stroke.
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