How to Tell if It's a Migraine or Brain Aneurysm

Medically Reviewed by Christopher Melinosky, MD on October 28, 2021
3 min read

If you have intense pain in your head, you might wonder if it's from a migraine or from a serious blood vessel problem called a brain aneurysm. The two conditions share some symptoms, but there are also key ways to tell them apart.

Your brain has many small vessels that carry blood. If the walls of one of those vessels is weak, it can bulge out and form a small blood-filled balloon.

This is a brain aneurysm. Many people can have one for years without having problems. If an aneurysm bursts, though, it can cause an extreme headache and other symptoms. You'll need emergency medical care since it can be life threating.

Doctors often describe the head pain caused by a burst aneurysm as a "thunderclap." The pain comes on in an instant, and it's very intense. It will feel like the worst headache of your life.

A migraine, on the other hand, tends to come on gradually. While the pain it causes may be intense, it usually doesn't hit you all at once.

The suddenness and intensity of a brain aneurysm are its hallmarks -- and the best way to tell it apart from a migraine.

Seizures are another symptom that may show up during a burst aneurysm. You don't get that with a migraine.

If you lose consciousness, it's also a sign that you have a brain aneurysm, not a migraine.

Migraine headaches and brain aneurysms can sometimes share some symptoms. It's rare, but an aneurysm that is large or growing can push on nerves or tissue and cause migraine-like symptoms, including:

  • Headaches
  • Pain above or behind the eyes
  • Numbness, usually in your face
  • Weakness
  • Vision changes
  • Abnormal eye movements

Sometimes the aneurysm may leak without fully bursting, causing headaches. You may hear your doctor call this a "sentinel bleed."

Tell your doctor if you get any of these problems.

Migraine headaches don't cause aneurysms to form or burst. And they aren't a sign that you're about to have a burst aneurysm.

Studies show that some people with an aneurysm that hasn't burst may get migraines in the weeks and months before it bursts. But there's no evidence that migraines and aneurysms happen at the same time.

Some research suggests that people who get migraines have a greater risk for a brain aneurysm, but more study is needed.

It's important to take severe headache pain and other symptoms seriously. Get immediate medical help if you notice problems such as a sudden, severe headache that's like a thunderclap.

Also get medical help right away if you or someone you're with has symptoms along with a headache such as:

Another reason to get immediate medical help is if your headache is different from the usual kind of headache you get. And call a doctor if you get a new type of headache but you're someone who never usually gets one.