De novo aneurysms ebs 2012

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De novo aneurysms ebs 2012

  1. 1. De Novo Cerebral Aneurysms: How often do they happen? Macquarie Neurosurgery Evidence Based Surgery presentation Date: March 8, 2012 Nirav J. Patel EBS presentation 1
  2. 2. Clinical case21F with a PMHx of SAH, clipping of rightparaclinoid aneurysm.No HTNFHx: noneSHx: Non-smoker6 years later left superior hypophysealaneurysm detected.How often should treated cerebral aneurysm patientsbe imaged?
  3. 3. Searchable question: What is the riskof developing a new aneurysm in apatient 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?
  4. 4. Search strategy P Intracranial Aneurysm/ AND De novo.mp OR new aneurysm.mp I NA C NA O Incidence/ or incidence.mp Or Risk Factors/
  5. 5. Medline Search results 1Preliminary search using “treated aneurysm”.
  6. 6. Medline Search results 2
  7. 7. Medline Search results 3Choosing the right MeSH subject headings, by looking throughthe complete reference.
  8. 8. Medline and Scopus: What’s thedifference? EBS presentation 8
  9. 9. Scopus Search results
  10. 10. Import to Endnote: Medline AND Scopus
  11. 11. Summary of search results Year ResultsMedline Search 1950-2012 38 articlesScopus search 1960-2012 91 articlesCochrane Review NA 1 articlesDuplicates References NA many articles Subtotal 91 articles Relevance (title/abstract) articles Bibliography/References articles TOTAL articles
  12. 12. Summary Table EBS presentation 12
  13. 13. Conclusions1. De novo aneurysm definitely happen.2. .5-1.2% annual risk of development3. Maybe higher in younger females4. Multiple aneurysms increase risk5. Don’t know about HTN, smoking, family history How often should treated cerebral aneurysm patients be imaged? < 5yrs.

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