Diagnosing a Ruptured Brain Aneurysm                          

Most brain aneurysms do not cause any symptoms and go undetected. However, sometimes a brain aneurysm can rupture. Often the first sign of a ruptured 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.

Computerized Tomography (CT scan)

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 before the scan. This fluid travels through your brain’s arteries and shows up when the CT scan is performed. This allows the healthcare provider to locate where the bleeding is and/or other problems.

A CT scan can show blood that has leaked from a torn aneurysm.

Magnetic Resonance Imaging (MRI scan)

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 as described above, and produces more detailed images of blood vessels.

A spinal tap (lumbar puncture)

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 inserts a needle into your lower spine. Fluid is removed through the needle and examined to check if blood is present and to find any other problems, such as an infection.

An arteriogram (or angiogram)

An arteriogram shows the size, shape, and location of an aneurysm. It can also reveal any vasospasm (a narrowing of the arteries), which can occur after an aneurysm ruptures, resulting 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 into your arteries and then travels to your brain.

• X-rays are then taken to be able to see your arteries and any aneurysms. This test may have some risks. 

• Your doctor will explain the risks before the test. If vasospasm is present, treatments can be done to limit its damaging effects.