The idea of population screening of unruptured intracranial aneurysms is interesting because, despite recent advances in surgical and endovascular treatment, the mortality related to aneurysmal subarachnoid hemorrhage reaches 30%. Screening is justified whenever the morbidity and mortality of the treatment (markedly lower for unruptured compared to ruptured aneurysms) overcomes the inherent risk of harbouring a brain aneurysm. Although, at present, this balance does not seem to favour population-based screening, it is justified in certain sub-populations with an increased risk of rupture.
In a review, an analysis is made of the requirements for implementing a screening program, when would it be justified, what is to be expected from treatment (in terms of effectiveness, morbidity and costs), and what medical-legal issues are relevant and to determine the usefulness of the program. A study protocol is proposed aimed at examining the usefulness of population screening for intracranial aneurysms by magnetic resonance angiography 1).