Brain aneurysm or headache how can i tell?

Aneurysm: Aneurysm rare, headache common. Only a proper neurologic workup can be certain of an aneurysm that never ruptured but is the source of the headache.

You can tell: If it is a ruptured aneurysm, headache is classically so severe, it is described as "worst in my life", and is associated with stiff neck, nausea and vomiting and perhaps rapid coma. Although rarely, we have found aneurysms in migraine pts, in my opinion these were co-morbidities unrelated to the headaches. Some nonruptured aneurysms will cause eye changes as they expand, especially double vision.