About half of people who experience a catastrophic aneurysm rupture report having a “sentinel headache” days or weeks before. This is a small leak that seals itself temporarily.
Sentinel headache characteristics:
- Sudden, severe (but not as severe as a full rupture)
- May last minutes to hours
- Often described as “the worst headache of my life” – until the real one comes
- May resolve completely, leading people to assume it was nothing
The danger: People who experience a sentinel headache are at extremely high risk of a catastrophic rupture within days to weeks. If you have a sudden, severe headache that seems unusual for you, seek medical evaluation—even if it goes away.
What to Do Immediately (Don’t Hesitate)
If you or someone with you experiences any of the above symptoms—especially suddenly:
Step 1: Call for emergency medical help immediately. Do not drive yourself to the hospital. Do not have someone drive you. Call an ambulance. Paramedics can begin treatment en route.
Step 2: Do not wait to “see if it gets better.” Minutes matter. The risk of re-bleeding is highest in the first few hours.
Step 3: Do not give aspirin or other blood thinners. If it’s a bleeding aneurysm, blood thinners will make it worse.
Step 4: Do not eat or drink anything. You may need emergency surgery or procedures requiring an empty stomach.
Step 5: Note the time symptoms started. This information helps doctors make treatment decisions.
Step 6: Do not leave the person alone. They may lose consciousness suddenly.
What About Aortic Aneurysms? (Different Symptoms)
Brain aneurysms get the most attention, but aortic aneurysms (in the chest or abdomen) are also dangerous. They often have no symptoms until rupture. But sometimes, they cause warning signs.
Thoracic (chest) aortic aneurysm symptoms:
- Deep chest pain or back pain
- Hoarseness (from pressure on the vocal cord nerve)
- Difficulty swallowing (from pressure on the esophagus)
- Shortness of breath
Abdominal aortic aneurysm symptoms:
- Deep, steady pain in the abdomen or lower back
- A pulsating feeling near the navel
- Pain that radiates to the groin or legs
If you have these symptoms, especially with risk factors (smoking, high blood pressure, age over 60), see a doctor.
