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. Clinical case
21F with a PMHx of SAH, clipping of right
paraclinoid aneurysm.
No HTN
FHx: none
SHx: Non-smoker
6 years later left superior hypophyseal
aneurysm detected.
How often should treated cerebral aneurysm patients
be imaged?

3. 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?

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. Medline Search results 1
Preliminary search using “treated aneurysm”.

6. Medline Search results 2

7. Medline Search results 3
Choosing the right MeSH subject headings, by looking through
the complete reference.

8. Medline and Scopus: What’s the
difference?
EBS presentation 8

9. Scopus Search results

10. Import to Endnote: Medline AND Scopus

11. 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

12. Summary Table
EBS presentation 12

13. Conclusions
1. De novo aneurysm definitely
happen.
2. .5-1.2% annual risk of
development
3. Maybe higher in younger
females
4. Multiple aneurysms increase risk
5. Don’t know about HTN,
smoking, family history
How often should treated cerebral aneurysm patients
be imaged? < 5yrs.