De novo aneurysms ebs 2012
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Transcript of De novo aneurysms ebs 2012
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