title: Clinical presentation of cerebral aneurysms.
abstract: Presentation of a cerebral aneurysm can be incidental, discovered at imaging obtained for unrelated causes, can occur in the occasion of imaging obtained for symptoms possibly or likely related to the presence of an unruptured aneurysm, or can occur with signs and symptoms at the time of aneurismal rupture. Most unruptured intracranial aneurysms are thought to be asymptomatic, or present with vague or non-specific symptoms like headache or dizziness. Isolated oculomotor nerve palsies, however, may typically indicate the presence of a posterior circulation aneurysm. Ruptured intracranial aneurysms are by far the most common cause of non-traumatic subarachnoid hemorrhage and represent a neurological emergency with potentially devastating consequences. Subarachnoid hemorrhage may be easily suspected in the presence of sudden and severe headache, vomiting, meningism signs, and/or altered mental status. However, failure to recognize milder and more ambiguous clinical pictures may result in a delayed or missed diagnosis. In this paper we will describe the clinical spectrum of unruptured and ruptured intracranial aneurysms by discussing both typical and uncommon clinical features emerging from the literature review. We will additionally provide the reader with descriptions of the underlying pathophysiologic mechanisms, and main diagnostic pitfalls.
authors.affiliation: Neurocentro della Svizzera Italiana, Ospedale Civico di Lugano, via Tesserete, 46, 6900 Lugano, Switzerland.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Cianfoni
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pravatà
authors.forename: Roberto
authors.initials: R
authors.lastname: De Blasi
authors.forename: Costa Silvia
authors.initials: CS
authors.lastname: Tschuor
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bonaldi
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology*; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D004244:Dizziness / Q000175:diagnosis / Q000209:etiology*; D006261:Headache / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D033162:Incidental Findings; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis*; D010808:Physical Examination / Q000379:methods