Call your doctor at once. Evaluation for a suspected rupture of a brain aneurysm must be performed immediately, most appropriately in a hospital's emergency department.

• If you have any questions about whether or not there is cause for concern, call your doctor for advice. The doctor most likely will advise you to seek care in a hospital's emergency department.
• If you are a close relative of someone with a known aneurysm, or ruptured aneurysm, inform your doctor. Your doctor will want to be aware of such information. You should realize, though, that you seldom need to be screened for an aneurysm unless you are having symptoms.

A ruptured aneurysm is a life-threatening event. Any headache  that is severe and comes on suddenly should prompt immediate evaluation by a doctor, particularly if the headache is associated with any of the following:

• Seizure
• Vomiting
• Alteration in consciousness
• Neurological defects such as inability to speak, to move an extremity, walk, severe dizziness, changes in your vision
• This evaluation most appropriately occurs in the emergency department.
• Rupture of an aneurysm frequently occurs at times of stress or physical exertion. Any severe headache , with or without the symptoms described here, should be investigated immediately.

People who experience migraine headaches   with an established headache pattern should seek evaluation for any headache that is severe, comes on suddenly, and is different from their usual headache pattern. This might include the following:

• A much more intense headache
• A headache of maximum intensity at the onset
• A headache without forewarning, among other symptoms

Family members, particularly siblings, of people with known aneurysms or a history of ruptured aneurysm are at higher risk for rupture and shoul

Anyone who has survived a ruptured aneurysm should be especially concerned and seek care immediately for any new or suspicious headache.

d seek care promptly for any of these symptoms:

• Unusual headache
• Head pain
• Eye pain
• Visual disturbances

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At this time doctors do not recommend screening family members for aneurysms that show no symptoms

• If you have 1 close family member who has had a rupture of an aneurysm, your lifetime risk of a ruptured aneurysm is about 1% at age 50 years and 2% at age 70 years.
• The risk of surgery to repair an aneurysm that exists but has no symptoms is 2-5%, which is clearly greater than the risk of hemorrhage into the brain for such people.

Screening is recommended for families who show no symptoms but who have 2 members with a ruptured aneurysm

• Siblings over age 30 years are at particularly high risk and should be screened.
• Current recommendations are that family members have an MRI angiography or helical CT angiography every 5 years.

The major modifiable risk factors for rupture of an aneurysm are the following. You can influence 2 of these directly. In cooperation with your doctor, you nearly always can control your blood pressure as well.

• Do not smoke cigarettes.
• Control high blood pressure
• Avoid binge drinking.

Additionally, the use of amphetamines (speed), cocaine, and even most medications for the common cold can all dramatically increase blood pressure and increase the risk of rupture in people with brain aneurysms

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