EBS presentation 1

De Novo Cerebral Aneurysms:

How often do they happen?

Macquarie Neurosurgery

Evidence Based Surgery presentation

Date: March 8, 2012

Nirav J. Patel

Clinical case

21F with a PMHx of SAH, clipping of right paraclinoid aneurysm.No HTNFHx: noneSHx: Non-smoker

6 years later left superior hypophyseal aneurysm detected.

How often should treated cerebral aneurysm patients be imaged?

Searchable question: What is the risk of developing a new aneurysm in a patient who has cerebral aneurysm(s)?

• P = Patients with cerebral aneurysms, who develop another cerebral aneurysm.

• I =

• C =

• O = What is the incidence? The risk of developing a new aneurysm?

Search strategy

PIntracranial Aneurysm/

AND

De novo.mp OR new aneurysm.mp

I NA

C NA

O Incidence/ or incidence.mpOr

Risk Factors/

Medline Search results 1

Preliminary search using “treated aneurysm”.

Medline Search results 2

Medline Search results 3

Choosing the right MeSH subject headings, by looking through the complete reference.

EBS presentation 8

Medline and Scopus: What’s the difference?

Scopus Search results

Import to Endnote: Medline AND Scopus

Summary of search results

Year Results

Medline Search 1950-2012 38 articles

Scopus search 1960-2012 91 articles

Cochrane Review NA 1 articles

Duplicates References NA many articles

Subtotal 91 articles

Relevance (title/abstract) articles

Bibliography/References articles

TOTAL articles

EBS presentation 12

Summary Table

Conclusions

How often should treated cerebral aneurysm patients be imaged? < 5yrs.

1. De novo aneurysm definitely happen.

2. .5-1.2% annual risk of development

3. Maybe higher in younger females

4. Multiple aneurysms increase risk5. Don’t know about HTN,

smoking, family history