Are there any signs before a rupture happens?

Ralf · August 6, 2026, 2:42pm

As one of many in the Watch & Wait group, what happened to you before the “explosion” changed your life? Knowing what to watch for would be helpful, so I would appreciate knowing what to expect. Here at BAF I have read about migraine triggers, “pops” and just passing out. I live alone, and would be very comforted by knowing other “triggers” that have saved lives. There is a generic list I check occasionally, but learning of other’s real life warning signs would be helpful, as that list may not be complete.

From the medical literature: Symptoms depend on the location of the aneurysm, whether it breaks open, and what part of the brain it is pushing on. Symptoms may include:

Double vision—I have had for years, eyeglass prescription now includes prism.
Loss of vision
Headaches—occasional, mild, one dose of 1000 mg Tylenol helps
Eye pain
Neck pain—occasional
Stiff neck–occasional
Ringing in the ears—pulsatile tinnitus, have had for years

A sudden, severe headache is one symptom of an aneurysm that has ruptured. Other symptoms of an aneurysm rupture may include:

Confusion, no energy, sleepiness, stupor, or coma
Eyelid drooping
Headaches with nausea or vomiting
Muscle weakness or difficulty moving any part of the body
Numbness or decreased sensation in any part of the body
Problems speaking
Seizures
Stiff neck (occasionally)
Vision changes (double vision, loss of vision)
Loss of consciousness

I don’t think about it much, but many other unrelated weird things are happening inside my brain, so maybe my subconscious is focusing on the aneurysm

Moltroub · August 8, 2026, 1:05pm

I’ve started a new topic for @Ralf taken from the welcomes of last week. I think this is a great topic and hope to read a lot of replies to what others experienced before they ruptured!

FinWhaleFan · August 8, 2026, 10:11pm

I agree with @Moltroub, this is a great topic!

I guess I should start off by saying that my aneurysm is in a rarer location, on the PICA (Brain basics courtesy of the Niekro Aneurysm & AVM Foundation), so that may impact what happened to me.

I was at home, prepping for a charity event on a Saturday and was walking in between the kitchen and the living room. I tried to move my left leg (“walk!”), but my left leg wouldn’t do it! ??? Basically I was dragging it along, and I had no motor control over it.

Somehow, I got to my cell phone and called my parents, while sitting on the ground (basically I was crawling around at this point, pulling myself using my right side). O.k., yes, I know what I really was supposed to do, but I was in denial! Of course they told me, call 9-1-1, so I hung up with them, and then called 9-1-1. I told them that I was not able to move my left leg, and so of course, they were going to send someone right over.

At this point, I realized I am on the second floor, and that there was no way I could get down the stairs to the locked front door on the first floor. Surely any attempt I would make to do that would result in me falling down the stairs, and that does not seem like a wise strategy at this point! How would I unlock the door to let EMT in?? Even worse, the chain lock was still on the front door as I hadn’t yet left the house that day.

I knew all of my closest-distance family members were not in the immediate area at that time, and wouldn’t be able to get to the house anytime soon.

Aha! The pet-sitter has a key! Sure enough, I texted her, she was in the area, so I asked if she could come unlock the door for EMT.

And, that’s it! That is all I know. I passed out soon after that, even before EMT arrived. The next thing I knew was that I woke up 3 days later after being medevac’d from my local hospital to the parent hospital where their main neurosurgery unit is. They put me into a medically-induced coma during that time.

For me, notice I did NOT have the classic thunderclap headache - or indeed any headache. I do not recall any type of pain - eye, neck - nor do I recall any loss/change of vision. I did not have any ringing in the ears either (although I do not have tinnitus, I am prone to fainting, so I am very familiar with that sensation). From the inside of me, I did not notice any facial weakness or difficulty speaking but I appreciate that it is harder to tell if that is happening to you.

I have zero doubt that plenty of folks will chime in to describe the thunderclap headache they had, but from my understanding it is not like any normal headache that you and I have experienced.

It may be helpful to read this in the interim Mayo Clinic description.

Thunderclap headaches are dramatic. Symptoms include pain that:

Strikes suddenly and severely

Peaks within 60 seconds

Can be accompanied by nausea or vomiting

With apologies to BAF, I really was very tempted, but logically it made no sense. They recently had a fundraising drive in which they would send you a yard sign in advance of September (awareness month). Since my HOA doesn’t allow yard signs I wouldn’t be able to put it out, alas defeating the purpose. On this yard sign, BAF has a new HEAD Initiative which reminds everyone of the warnings signs of a rupture, so it seemed right to highlight that in case it is an easy mnemonic:

H = Headache
E = Eyes
A = Alertness
D = Dial 9-1-1

So, admittedly from my tiny little corner of the PICA world, a rupture is big, bad AND ugly. When it happens, you know something serious just happened, there is just no questioning of that, but I appreciate that others may have had radically different experiences.

Something you may want to consider is - IF - it should happen to you, in a similar way that it did to me, is how would someone get to you? Do you have enough trusted people around you who can get to you easily or help out EMT? What steps can you take in advance to prepare for the worst while hoping for the best?

Thanks again for asking and putting up with my rambling! Can’t wait to hear what others say!

Fin Whale Fan

Leeh · August 11, 2026, 3:20pm

I experienced a rupture of a basilar tip aneurysm. I’d had a particularly busy day, it was particularly hot outside and I was in a particularly agitated mood because I was busy, it was hot and my daughter was due to start school the following day. I was standing in the kitchen buttering toast and without any warning felt a warm rush of liquid inside my head. I felt it first at the very top of my head and then at the back. There was no pain. There was just a sudden realisation that something was very, very wrong and I had presence of mind to sink to my knees with my head on the floor. I woke up some time later with my 75 year old mother bent over me smacking my cheek and calling my name, my 19 year old daughter asking what was wrong and I clearly recall being unable to open my eyes, or speak. It was then that I realised I had a terrible headache. I say terrible and not the worst because although it was the worst, I had experienced headaches like that before, “migraines”, the difference I would come to realise was this one did not budge, not even with the morphine they pumped me full of at the hospital. That headache arrived and stayed until a week after the coiling procedure.
In hindsight there are some things that stood out in the months and weeks leading up to the rupture which I have mentioned to my medical team and have been told may, or may not, have been attributable to the imminent rupture.
I have chronic headaches, daily and for years. Every so often I would get a particularly bad migraine if I did not treat a headache with enough urgency. I still get headaches, daily, but they feel entirely different to what I experienced prior to the rupture. I am tempted to say that I actually previously experienced migraines almost daily, and have not experienced one since.
I experienced ear and jaw pain in the weeks leading up to the rupture. Never felt it again since.
I experienced pressure behind my right eye - which I regularly complained of in weeks leading up to the rupture and I have only felt that same pressure since just before a focal seizure would start (I only had seizures after being discharged and they have since stopped, so has the pressure in my eye)
My right hand went numb on occasion prior to the rupture.

All this must be taken in the context that I was under extreme work pressure and stress in the months leading up to the rupture, I was sleeping very little and was living off energy drinks and boosters. There is also a suspicion amongst my doctors that I may well have had “leaks” in the months/years leading up to the eventual rupture, but there is no way to confirm this.

I have since the rupture never lit another cigarette, touched an energy drink or booster again. I was on leave for a full 6 months before returning to work a month ago where I strictly manage my work stress and the hours I work. I do still find I am very easily fatigued but I am not certain whether this is a side effect of recovery, or if I am now only realising how fatigued I always was from over-working myself.

Sadly, I don’t think there are any hard and fast warning signs of an impending rupture, much as there are often no symptoms of the presence of an aneurysm before it ruptures.

After what myself, and my family experienced when our lives were turned upside down by the rupture of an aneurysm I never knew I had, I would be very tempted to offer to anybody the simple advice of everybody should treat themselves as if there is an aneurysm waiting to rupture, don’t smoke, keep your blood pressure in check, no stress is worth dying for and energy drinks are a poison not worth risking your life for.

Moltroub · August 12, 2026, 9:59am

Ralf, you’ve done a wonderful list of possibilities! I ruptured at the LICA bifurcation. I had no early warning signs. I know I was told it was a thunderclap headache but it felt like a lightening strike to me. Nope never been hit by lightening, but it was an extremely sharp pain that ran done my spine. Prior to my rupture I had stress headaches and eye strain headaches. The stress headache always gave me a knot on the right side of my neck right below my skull. Eye strain due to having so much documentation to do on the computer. I had a very stressful job, mostly due to changing politics in the office and the State and Federal government adding longer forms. I thank God and the Universe every day that I ruptured on my day off and not driving with someone else’s kids in my vehicle or even out on the road.

We have had many members who have shared they had sentinel bleeds prior to a rupture, I hope they come talk to us about their experiences. I’ve no idea what one feels like.

Ralf · August 15, 2026, 1:15pm

Thanks loads, your story is just the kind of input I am looking for. The H.E.A.D. mnemonic is great.

About the locked door (I live alone)–I keep the chain on, but it’s not locked or dead bolted so EMS can get in. Only the chain will break, then they can use the knob lock to secure the door. (I live in a very safe neighborhood, one of my requirements when I looked to move last year.)

Here in Winston Salem, NC they want you to use a “KnoxBox” for emergency entry. Approximately $249 and emergency responders have a master key. Don’t think I will do that, will see if other options are available, like realty lock box.

My 91 year old mother fell and broke her pelvis last year and the EMTs had to break her condo door in (lock & deadbolt). No “EMS key box” anywhere in her complex. Expensive and time consuming to replace! (She at some point had “infantry crawl” training which got her to the phone, but not up high enough to unbolt her door.) Moved to assisted living in April.

Someone replied to your post.

| FinWhaleFan
August 8 |

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