Many aneurysms cause no symptoms until they get quite large or rupture. Bleeding from a ruptured aneurysm irritates the meninges. The meninges are layers that cover and protect the brain and spinal cord. If the amount of blood in the space under the meninges is large, other blood vessels may go into spasm. This can cause a sudden, severe headache. Headache is usually followed by neck pain and neck stiffness.
A large blood clot can also press on brain tissue around the meninges. When this happens, the person may show progressive drowsiness. Other symptoms, such as paralysis and visual impairment, can also develop.