Dr. Huynh Van Muoi Mot, Deputy Head of the Emergency Department at Tam Anh General Hospital, Ho Chi Minh City, reported that the patient suffered from a severe headache, neck and shoulder pain, vomiting, and fatigue. These were unusual signs of an intracranial issue, not a musculoskeletal condition, as cervical spondylosis typically causes dull pain that worsens with neck movement and rarely leads to vomiting.

Brain magnetic resonance imaging (MRI) results revealed subarachnoid hemorrhage caused by a ruptured aneurysm of the left internal carotid artery at the posterior communicating segment. Blood had spread into the subarachnoid space around the brain, cisterns around the brainstem, and into both lateral ventricles.

Dr. Muoi Mot advises Ms. Tim's family on treatment methods. Photo: Tam Anh General Hospital.

Dr. Muoi Mot advises Ms. Tim's family on treatment methods. Photo: Tam Anh General Hospital.

An aneurysm is a weak section of an artery wall that bulges like a balloon. When an aneurysm ruptures, blood floods into the subarachnoid space (the fluid-filled area surrounding the brain), increasing intracranial pressure and irritating the meninges, which causes severe headaches, vomiting, and a stiff neck. This is a dangerous form of hemorrhagic stroke.

After identifying the cause, a multidisciplinary team of doctors consulted and recommended brain aneurysm surgery. Surgeons performed a craniotomy to access the ruptured aneurysm, then placed a specialized titanium clip at its neck. This completely blocked blood flow into the aneurysm while ensuring normal circulation through the arteries supplying the brain.

Post-surgery, Ms. Tim's headaches subsided, vomiting ceased, and no neurological deficits such as weakness, paralysis, or speech disorders were observed. She was discharged after five days of monitoring. At a follow-up appointment one month later, her health was stable, with no recurrence of pain.

According to Dr. Muoi Mot, early-stage brain hemorrhage often lacks distinct symptoms and can be mistaken for musculoskeletal pain or cervical spondylosis. Detailed inquiry into the onset and characteristics of the pain helps doctors determine appropriate diagnostic methods.

The cause of a ruptured brain aneurysm may be related to hypertension. Patients with congenital vascular wall abnormalities, vascular malformations, or factors that degenerate artery walls have a higher risk of aneurysm formation.

Individuals experiencing unusual headaches, especially sudden, severe, and prolonged pain over several days accompanied by nausea and fatigue, should seek immediate medical attention. Regular health check-ups can help detect aneurysms early, before rupture, increasing treatment opportunities and reducing stroke risk.

Nhu Ngoc

The patient's name has been changed.