Signs and Symptoms
The typical symptom of a ruptured berry aneurysm is the development of a headache so bad that the patient may say "it is the worst headache I have ever had", classically known as "thunderclap headache".
Most intracranial berry aneurysms do not show any symptoms unless they have ruptured, which causes bleeding in the brain. Small aneurysms that maintain their size generally will not show symptoms. But larger aneurysms that are steadily growing can put pressure on nerves and tissues. Signs of an aneurysm that has not ruptured include (but are not limited to):
- Headaches
- Vomitting
- Double vision (Diplopia)
- Loss of vision
- Eye pain
- Stiff neck (Meningismus)
- Sentinel or warning headaches. These are headaches that are caused by leakage of blood into the brain for days up to weeks prior to the aneurysm's rupture (only a small percentage of patients experience a sentinel headache before rupture).
- Loss of consciousness
- Seizures
General symptoms of ruptured aneurysm are:
- Sudden, severe headache
- Lethargy
- Confusion and/or stupor
- Seizures
- Sudden mood swings (Impulsivity, Irritability, Poor temper control)
- Speech impediment (dysarthria)
- Eyelids dropping, especially unilaterally (Ptosis)
- Movement disorders (ataxia), especially unilaterally.
- Death
Symptoms of a ruptured aneurysm depending on site of aneurysm in brain:
If the aneurysm is in carotid territories, the symptoms are:
- Visual deficit
- Visual field defects
- Oculomotor nerve palsy
If the aneurysm is in cavernous sinus, the symptoms are:
- frontal headache
- orbital headache, pulsating exophthalmos, retinal hemorrhage, occlusion of central retinal vein, and hemorrhagic edema of eyelid
- Oculomotor nerve palsy
- Sixth nerve palsy
- Horner syndrome
- Sensory deficit over are supplied by V1 and V2 divisions of Trigeminal nerve
If the aneurysms is in vertebrobasilar territories, the symptoms are:
- Trigeminal nerve deficit
- Acoustic nerve deficit
- Lower cranial nerve deficit
- Brainstem symtoms
Read more about this topic: Intracranial Berry Aneurysm
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