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Headaches Due to Brain Hemorrhage (Aneurysm)
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A Headache may occur as a result of a leaking or ruptured aneurysm (abnormal ballooning or out-pouching of a weakened section of the brain's blood vessels). As the brain is enclosed in the skull, the leaking of blood from one of these aneurysms can lead to blood accumulating in the space surrounding the brain (subarachnoid hemorrhage) or in the brain itself (intracerebral hemorrhage).
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The cause of aneurysm is not well known. There is a genetic predisposition in persons with Polycystic Kidney Disease or coarctation of the aorta; a tendency to inheritance among 5 to 7 percent of aneurysms patients; and a bacterial or fungal infection occurs in 2.6% - 6% of all Brain Aneurysm cases. Socio-economic background, diet(N), and general health status also have been considering factors.
Examination:
1. Focal neurological deficits
2. Neck Stiffness
if aneurysm has ruptured
Imaging:
1. Cerebral Angiography
(dye is injected into the carotid artery to get an image of the blood vessels of the brain)
2. CT scan will usually show bleeding after an aneurysmal rupture
3. MRI
Laboratories:
Lumbar puncture (spinal tap) -- cerebrospinal fluid will show blood after an interval of time if there
is aneurysm rupture. Electrocardiogram: may cause EKG abnormalities
Subarachnoid Hemorrhage
may cause heart(N) abnormalities
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Unruptured aneurysms:
1. Large aneurysms are surgically clipped at their bases to prevent rupture.
2. Small aneurysms (less than 1/2 centimeter) without symptoms are usually followed with repeated cerebral
angiographies.
Ruptured aneurysms:
1. Surgical clip placed at the base of the aneurysm
2. Aminocaproic acid may be considered, but has complications
3. Calcium
channel blockers such as Nimodipine may prevent spasm of the artery where the aneurysm ruptured.
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