Can I have a brain aneurysm without feeling anything?
Yes, a brain aneurysm can be present without causing symptoms and be found by chance. What an incidental finding is, what to review, and when to call 911.
By Dr. Martin Roberto Casas MartínezSep 12, 20266 min read
In this article
- What does it mean when a finding is “incidental”?
- Why might an aneurysm cause no symptoms?
- What symptoms mean you should call 911?
- What should you review in the report, and what should you bring to the consultation?
- What factors does the specialist assess when deciding on follow-up?
- Frequently asked questions
- What should I ask at the consultation?
- References
Summary: Yes: a brain aneurysm can exist without causing any symptoms and is often discovered by chance on an MRI or CT scan ordered for another reason. Not feeling anything does not indicate the condition of the aneurysm or rule out the need for a specialist assessment. If you have a sudden, severe headache or other sudden symptoms, call 911.
Many people wonder whether they could have a brain aneurysm without feeling anything after receiving an unexpected report. The answer is yes: most unruptured aneurysms do not cause symptoms, which is why the finding often comes as a surprise. The following explains why this happens, what it means for you, and what may be helpful to review with your medical team.
What does it mean when a finding is “incidental”?
“Incidental” describes how the aneurysm was discovered, not its severity or behavior. It means the imaging study (an MRI or CT scan) was done for another reason and the aneurysm showed up on the images even though no one was looking for it.
The reason for the study may have been a chronic headache, a head injury, dizziness, or another concern. According to MedlinePlus, a person can have an aneurysm without any symptoms, and this type of aneurysm may be found during an MRI or CT scan done for another reason.
An incidental finding does not mean that the aneurysm is harmless or does not need follow-up. That assessment should be made by a specialist based on the report, images, and your medical history.
Why might an aneurysm cause no symptoms?
An aneurysm is a weakened area in the wall of an artery in the brain that bulges outward. Most do not cause symptoms until they grow, leak blood, or rupture; small aneurysms that are not growing usually cause no symptoms.
When an aneurysm grows and presses on nearby nerves or tissue, it can cause pain behind or above the eye, double vision, a drooping eyelid, or numbness on one side of the face. These pressure-related symptoms do not mean it has ruptured, but they warrant prompt medical assessment; if they appear suddenly, call 911.
An aneurysm that does not grow can remain silent for years. Even so, the absence of symptoms is not a sign that it is stable or a sufficient basis for deciding between monitoring and treatment: that decision depends on several factors that the specialist evaluates individually.
What symptoms mean you should call 911?
Call 911 right away, without waiting for an appointment, if you have a sudden, very severe headache unlike any you have had before. This symptom may indicate that the aneurysm has ruptured and is a medical emergency.
Other warning signs that require immediate attention include:
- •Sudden vision loss, double vision, or a dilated pupil.
- •Sudden weakness or numbness in the face, an arm, or a leg.
- •Sudden difficulty speaking or understanding.
- •Loss of consciousness, acute confusion, or a stiff neck with a severe headache.
If you have any of these warning signs, do not wait to see if they go away or schedule a consultation as your first step: call 911.
What should you review in the report, and what should you bring to the consultation?
The written report is a starting point, not a conclusion. Check whether it mentions the size and location and describes the aneurysm as unruptured, and bring the original images: the specialist needs to review them to make their own assessment.
It is also helpful to gather any previous studies you have (comparing them over time can help determine whether the aneurysm has changed), a list of your current medications, any family history of aneurysm or brain hemorrhage, and any recent symptoms, even if they have gone away.
A report that does not mention a rupture does not confirm that the aneurysm is stable or does not need attention. The specialist should interpret the images in the context of your complete clinical history.
What factors does the specialist assess when deciding on follow-up?
The decision to monitor or treat an unruptured aneurysm depends on a combination of factors: the aneurysm’s size, growth, location, and shape, as well as the person’s age, health, and family history.
Aneurysm growth is associated with a higher risk of rupture, so comparing studies over time is part of follow-up. High blood pressure and smoking are modifiable risk factors that the specialist often addresses.
Not all unruptured aneurysms need treatment: some are monitored with periodic imaging studies, while others are treated on a planned basis. The approach and urgency depend on the individual clinical context, not on the absence of symptoms.
Frequently asked questions
If I don’t feel anything, can I stop having follow-up studies?
Not on your own. Untreated unruptured aneurysms may be monitored with periodic imaging studies, and the absence of symptoms does not mean the aneurysm is stable. Any change to the follow-up plan should be discussed with your specialist.
Should my family members have a study to rule out an aneurysm?
There is no general recommendation to screen everyone who has no symptoms. Family history is one of the factors the specialist considers, so it is worth asking about this during your consultation to find out whether it applies to your family.
Does a common headache mean the aneurysm is growing?
Not necessarily: common headaches have many causes. A sudden, severe headache unlike any other is what requires immediate attention. You should mention any changes in your usual headaches during your follow-up consultation.
What should I ask at the consultation?
If you have sudden symptoms like those described, call 911 first. If your aneurysm was found by chance and you are arranging an assessment, these questions may help:
- •What size is my aneurysm, where is it located, and what does that mean in my case?
- •Do I need additional tests to complete the assessment?
- •What is the difference between monitoring and treating it in my situation, and how often would I need imaging studies?
- •What risk factors can I address starting now?
For non-urgent questions or to request an individual assessment, you can contact the office.
Informational notice: This content is for informational purposes and does not replace a medical consultation or constitute a diagnosis.
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