An aneurysm is an abnormal bulging or ballooning in the wall of an artery or vein that fills with blood. Arteries are blood vessels responsible for carrying oxygen-rich blood from the heart to the rest of the body. Aneurysms can form in almost any blood vessel, including those in the brain, heart, intestines, and abdomen. They usually develop when part of the vessel wall becomes weakened or thinned over time.

Most small aneurysms do not cause noticeable symptoms. However, symptoms may appear when an aneurysm grows larger, begins to leak, or ruptures. Aneurysms can occur at any age, but they are most commonly diagnosed in adults between 30 and 60 years old. The symptoms depend on the aneurysm’s size and location. Common warning signs may include sudden headaches, pain in the chest, neck, or abdomen, blurred vision, dizziness, or skin discoloration. In many cases, aneurysms are about the size of a small berry, but even small ones can be dangerous if they rupture.

If an aneurysm bursts, symptoms typically appear suddenly and require immediate emergency medical care.

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Aneurysm Symptoms

Symptoms vary based on the location of the aneurysm and whether it has ruptured or is pressing on nearby tissues. Common symptoms associated with aneurysms include:

• Sudden, severe headache

• Abdominal or lower back pain

• Discoloration of the legs or feet

• Dizziness or lightheadedness

• Blurred or double vision

• Confusion or difficulty concentrating

Aneurysms are classified according to their location, and their symptoms differ depending on whether they remain intact or rupture.

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Cerebral (Brain) Aneurysm Symptoms

Cerebral aneurysms form in arteries of the brain, most commonly at the base of the skull. When a brain aneurysm becomes large, it can press on brain tissue and nearby nerves. This pressure may cause:

• Pain behind or above the eyes

• Facial paralysis or weakness on one side

• Enlarged pupils

• Drooping eyelids (ptosis)

• Blurred or double vision

If a cerebral aneurysm leaks or ruptures, it can cause a subarachnoid hemorrhage, a type of bleeding in the brain that can lead to stroke and permanent brain damage. Symptoms of a ruptured or leaking cerebral aneurysm include:

• A sudden, intense headache that may last for hours or days

• Nausea and vomiting

• Neck stiffness

• Sensitivity to light

• Seizures

• Loss of consciousness or coma

• Weakness or paralysis in the arms or legs

• In severe cases, death

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Aortic Aneurysm Symptoms

An aortic aneurysm develops in the aorta, the main artery that carries blood from the heart to the rest of the body. Aortic aneurysms are the most common type of aneurysm.

Aneurysms in the chest are called thoracic aortic aneurysms, while those below the chest are known as abdominal aortic aneurysms.

Symptoms of thoracic aortic aneurysms may include:

• Sudden pain in the chest or upper back

• Difficulty breathing

• Trouble swallowing

• Shortness of breath

Abdominal aortic aneurysms are more common and may cause:

• Pulsating or throbbing pain in the abdomen or back

• Pain radiating to the groin, buttocks, or legs

• Discoloration of the lower extremities

• A noticeable pulse near the navel

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Popliteal Artery Aneurysm Symptoms

Popliteal artery aneurysms occur in the artery behind the knee. Many cases are asymptomatic and discovered incidentally during imaging tests.

Symptoms usually appear when the aneurysm enlarges and compresses surrounding nerves and veins. These may include:

• Leg pain or cramping

• Paresthesia (a “pins and needles” sensation)

• Muscle weakness

• Blood clots (thrombosis)

• A pulsating mass behind the knee

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Splenic Artery Aneurysm Symptoms

Splenic artery aneurysms occur in the artery supplying blood to the spleen. They account for 60–70% of visceral artery aneurysms, which affect arteries that supply organs such as the kidneys, liver, spleen, and intestines.

Symptoms may include:

• Abdominal pain that may radiate to the left shoulder

• Internal bleeding

• Hematemesis (vomiting blood)

• Sudden drop in blood pressure if rupture occurs

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Aneurysm Symptoms in Men vs. Women

There are no major differences in the symptoms experienced by men and women. However, differences exist in the types of aneurysms that are more common between sexes.

Cerebral aneurysms occur more frequently in women than in men. Research published by the American Heart Association indicates that women have a 1.4 times higher risk of brain aneurysm rupture. Women also tend to develop larger aneurysms, which increases the likelihood of rupture.

In contrast, abdominal aortic aneurysms are more common in men. Studies show that rupture rates are higher in men, partly due to higher smoking rates, which is a major risk factor for vessel wall damage.

More research is still needed to fully understand why these sex-based differences occur.

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When to See a Healthcare Provider

Symptoms of aneurysms often appear suddenly once the aneurysm enlarges or ruptures. A ruptured aneurysm is a medical emergency and can be fatal without immediate treatment.

Seek emergency medical care if you experience a sudden, severe headache, especially if accompanied by:

• Double vision

• Nausea or vomiting

• Neck stiffness

• Sensitivity to light

Not all aneurysms grow large or rupture. Many small aneurysms are discovered incidentally during imaging for unrelated conditions. Screening is recommended for individuals over age 65, those with a family history of aneurysms, high blood pressure, or a history of smoking. Early detection allows doctors to monitor aneurysms and intervene before life-threatening complications occur.