Migraine vs. aneurysm: The differences and the dangers

People can mistake an aneurysm for a migraine headache, delaying care and possibly leading to significant harm. Learn the differences and what to do.

People can mistake an aneurysm for a migraine headache, delaying care and possibly leading to significant harm. It is important to learn the differences and what to do when warning signs of an aneurysm are present.

If you experience a severe headache (some describe it as the worst headache of their life) and it comes on suddenly, call 911.

A brain aneurysm is a weak, bulging area in an artery in the brain. This is similar to a weak spot on a tire’s inner tube. Because the wall of the aneurysm is thin and weak, the aneurysm can rupture. Aneurysm rupture is one of the most devastating medical emergencies. The resulting bleeding in the brain can cause significant brain damage and even death.

Pain from a bleeding brain aneurysm sometimes can be confused with a migraine headache. Wrongly perceiving a severe headache as a migraine that will eventually resolve on its own can delay treatment and can have disastrous consequences.

Therefore, it’s very important to learn the differences and what to do if you experience the warning signs of a brain aneurysm bleed.

Migraine Symptoms Summary

According to the National Headache Foundation, migraine symptoms vary from person to person, but the following are the most common:

  • Recurrent headaches, lasting four to 72 hours
  • One-sided, pulsating, moderate-to-severe pain
  • Decreased ability to function
  • Nausea and/or vomiting
  • Sensitivity to light
  • Sensitivity to noise

Other, less common migraine symptoms may include sweating or cold hands, diarrhea, pale skin color and scalp tenderness, or pain from touch or pressure (such as a necklace touching skin, hair brushing or shaving).

Norton Neuroscience Institute

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Aneurysm Symptoms Summary

To understand how the experience of a ruptured brain aneurysm is different from that of a migraine, here’s a look at symptoms, according to the Brain Aneurysm Foundation:

  • Sudden and severe headache, often described as “the worst headache of my life”
  • Nausea/vomiting
  • Stiff neck
  • Blurred or double vision
  • Sensitivity to light
  • Seizure
  • Drooping eyelid
  • A dilated pupil
  • Pain above and behind the eye
  • Loss of consciousness
  • Confusion
  • Weakness and/or numbness

Related Content: New device is big advancement in brain aneurysm treatment

Important Differences Between Migraine and Aneurysm Symptoms

There is definitely some crossover in the symptoms of migraines and ruptured brain aneurysms.  Symptoms such as nausea and vomiting, blurred or double vision, and sensitivity to light occur in both conditions.

There are, however, some important differences. The pain from a ruptured brain aneurysm is often described as the worst headache of a person’s life. The pain comes on more suddenly and is more severe than any previous headaches or migraines.

In contrast, migraine headaches usually come on gradually. Migraines often cause moderate to severe throbbing pain or a pulsating sensation on one side of the head. They can include an aura, which is usually a warning sign that the migraine is about to start. Auras can include visual disturbances or flashes of light.

“Doctors may find an unruptured aneurysm because a patient presents with unrelated headaches, or after a head trauma, leading the doctor to order a CT [computed tomography scan] or MRI [magnetic resonance imaging scan],” said Shervin R. Dashti, M.D., Ph.D., neurosurgeon with Norton Neuroscience Institute .

The type and the size of the aneurysm and any risk factors determine how dangerous a particular aneurysm is. Ruptured brain aneurysms always require emergency treatment. With unruptured aneurysms, only those deemed to be at relatively high risk of rupture are treated.

Aneurysm Treatment

Treatment usually involves minimally invasive methods to thread a special catheter from the patient’s arm, through the radial artery into the arteries of the brain and into the aneurysm sac, according to Dr. Dashti. The method allows the doctor to block off the aneurysm from the inside.

Occasionally, it may be necessary to surgically open the skull and place a titanium clip across the neck of the aneurysm to treat it.

Insert aneurysm-illo from images task

Either procedure is intended to prevent the aneurysm from rebleeding and causing more brain damage.

At Norton Brownsboro Hospital, a Comprehensive Stroke Center, fellowship-trained endovascular and cerebrovascular neurosurgeons perform over 150 aneurysm treatments each year.

If your headaches or migraines are not sudden and terribly severe, talk to your primary care provider or learn more about our board-certified headache specialists.


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