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Hemodynamic Characteristics at the Rupture Site of Cerebral Aneurysms: A Case Study.
MedLine Citation:
PMID:  22922678     Owner:  NLM     Status:  Publisher    
BACKGROUND AND IMPORTANCE:: Hemodynamics play an important role in the mechanisms of aneurysm formation, growth, and rupture. However, little is known regarding hemodynamics of rupture sites. CLINICAL PRESENTATION:: We incidentally acquired three-dimensional images before and at the moment of rebleeding of a cerebral aneurysm in a patient. Comparison of these two images enabled precise identification of the rupture site. Based on computational fluid dynamics simulation, we propose there are characteristic hemodynamic parameters of the rupture site in cerebral aneurysms. We evaluated flow velocity, wall shear stress (WSS), pressure, and the oscillatory shear index to determine characteristic parameters at the rupture site.Among the hemodynamic parameters in the cardiac cycle, the rupture site was most markedly distinguished by a combination of low WSS at end-diastole and high-pressure at peak systole. The flow patterns around the rupture site uniquely changed in the cardiac cycle. The rupture site was an impingement zone at peak systole. Flow separation at the rupture site was observed at end-diastole. CONCLUSION:: In this case, a region with low WSS at end-diastole and high pressure at peak systole was at the rupture site. A possible mechanism of rupture in this particular aneurysm is that low WSS at end-diastole caused degeneration and thinning of the aneurysm wall, and high pressure at peak systole (impingement zone) resulted in rupture of the thinning wall.
Kenichi Kono; Takeshi Fujimoto; Aki Shintani; Tomoaki Terada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-23
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama, Japan.
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