Often, the first symptom of a brain aneurysm is a sudden, severe headache. Many patients describe it as the worst headache of their lives. A physical exam and a health history help to pinpoint the problem. If a brain aneurysm is suspected, special tests can confirm it. Test results can also help your health care team plan treatment.
A computerized tomography (CT) scan is a fast and painless test that creates an image of your brain. It shows whether any blood has leaked around or into your brain. In some cases, CT angiography may be done. This test produces an enhanced image that can show a brain aneurysm. For the test, a contrast fluid is injected into your vein. This fluid travels to your brain arteries. Then the CT scan is done to locate bleeding or other problems.
A magnetic resonance imaging (MRI) scan uses computer-generated radio waves and a powerful magnetic field to create detailed pictures of the brain. MR angiography is performed similarly to CT angiography above, produces more detailed images of blood vessels.
Cerebrospinal fluid (CSF) flows in and around your brain. It also flows around your spinal cord. A spinal tap, also called a lumbar puncture, can be done to show if blood has leaked into your CSF. Your health care provider numbs your lower back with a local anesthetic (pain medicine). Then he or she inserts a needle into your lower spine. Fluid is removed through the needle and examined to check if blood is present and rule out other problems, such as infection.
An arteriogram shows the size, shape, and location of an aneurysm. It can also reveal any vasospasm. This can occur after an aneurysm ruptures. It results in limiting the normal blood flow to your brain. For this procedure, you receive a local pain medicine. Then, your doctor guides a thin tube (catheter) through your arteries, from your groin to your neck. Contrast fluid is released. It travels to your brain. X-rays are then taken, showing your arteries and any aneurysms. This test has some risks. Your doctor will explain them before the test. If vasospasm is present, treatments to limit its effects can be used.