Choosing Wisely

Screening Tests for Brain Aneurysms

When you need them—and when you don’t

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A brain aneurysm is a weak area in the wall of a blood vessel in the brain. It can burst and cause a stroke, and can even lead to death.

Doctors use imaging tests—like CT scans or MRIs—to screen for brain aneurysms. That may sound like a good idea. But the tests and follow-up can do more harm than good. Here’s why:

Screening tests can lead to unneeded follow-up and treatment.

Brain aneurysms are rare. So when doctors order imaging tests, they usually don’t find any aneurysms.

That means patients are exposed to risks without any benefit.

Sometimes, a CT scan or MRI will show something on the image that is unclear. This can lead to more tests, which may add to your risks.

A CT scan or MRI might also find small “incidental aneurysms” that may never be a problem.

Imaging tests cost a lot and have risks.

Depending on your insurance, a CT scan or MRI of the head can cost from $650 to $1,000. Follow-up testing or treatment can add a lot to the costs.

Also, CT scans expose you to radiation.

When do you need screening tests for brain aneurysms?

Screening tests can be a good idea if:

  • You had a brain aneurysm in the past.
  • You had a type of stroke called a subarachnoid hemorrhage. It’s caused when an aneurysm bursts and there’s bleeding between the brain and the tissue around it.
  • You have two or more close relatives who have had aneurysms.
  • You have other risks for aneurysms, such as these genetic conditions: Marfan Syndrome, Ehlers-Danlos syndrome IV, or Polycystic kidney disease.

You may need to be evaluated if you have symptoms of a burst aneurysm.

The main symptom is an unusual, sudden, severe headache. Often patients say it’s “the worst head­ache of my life.” Other symptoms may include:

  • A stiff neck
  • Pain in the face
  • Seeing double
  • Light sensitivity
  • Vision loss
  • Odd eye movements
  • A seizure or change in speech or alertness




Advice from Consumer Reports

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2015 Consumer Reports. Developed in cooperation with the American Association of Neurological Surgeons. To learn more about the sources used in this report and terms and conditions of use, visit