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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 the health care team plan treatment.
A CT (computerized tomography) scan is a fast and painless test that creates an image of the brain. It shows whether any blood has leaked around or into the 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 a vein. This fluid travels to the brain arteries. Then the CT scan is done to locate bleeding or other problems.
Cerebrospinal fluid flows in and around the brain. It also flows around the spinal cord. A spinal tap (lumbar puncture) can be done to show if blood has leaked into the CSF. The lower back is numbed with a local anesthetic (pain medicine). Then a needle is inserted in the lower spine. Fluid is removed through the needle and examined to rule out other problems, such as infection.
An arteriogram shows the size, shape, and location of an aneurysm. It can also reveal any vasospasm. After local anesthesia, a thin tube (catheter) is guided through the arteries from the groin to the neck. Contrast fluid is released. It travels to the brain. Then x-rays are taken, showing the arteries and any aneurysms. This test has some risks. They will be explained before the test.