ArticleJournal of neurosurgery2025
Competing pathways of intracranial aneurysm growth: linking regional growth distribution and hemodynamics.
Article in Journal of neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Possible hemodynamic mechanisms in the size change of cerebral aneurysms: an exploratory study.Quantitative imaging in medicine and surgery · 2026Article
- Dome-remnant dissociation after coil embolization of a basilar tip aneurysm: serial MR cisternography, silent MRA, and computational fluid dynamics findings suggest early hemodynamic redistribution. Illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Investigation of Contrast Retention in PCOM Aneurysms as a Possible Marker for Instability and Rupture.International journal for numerical methods in biomedical engineering · 2026Article
- Cerebral vascular tortuosity and aneurysm formation and rupture: a novel vessel tortuosity scale.Experimental neurology · 2026Article
- Individualized treatment for pediatric intracranial aneurysms in China: case series and literature review.Frontiers in surgery · 2026Article
- Intracranial Aneurysm Wall Phenotypes: Clinical, Morphological, and Hemodynamic Influences.Stroke (Hoboken, N.J.) · 2025Article
- Internal carotid artery bifurcation aneurysms are probably formed to decrease the abnormally-enhanced hemodynamic stresses caused by direct flow impaction.Quantitative imaging in medicine and surgery · 2025Article
- Flow patterns inside the cerebral aneurysms affect aneurysm wall thickness.Neurosurgical review · 2025Observational
- Predictive modeling and machine learning show poor performance of clinical, morphological, and hemodynamic parameters for small intracranial aneurysm rupture.Scientific reports · 2025Article
- Analysis of the Role of Vasa Vasorum in the Oxygen Transport to the Aneurysm Wall.International journal for numerical methods in biomedical engineering · 2025Article
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5 authors.
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Abstract
objectiveThe complex mix of factors, including hemodynamic forces and wall remodeling mechanisms, that drive intracranial aneurysm growth is unclear. This study focuses on the specific regions within aneurysm walls where growth occurs and their relationship to the prevalent hemodynamic conditions to reveal critical mechanisms leading to enlargement.
methodsThe authors examined hemodynamic models of 67 longitudinally followed aneurysms, identifying 88 growth regions. These regions (of enlargement) were pinpointed through alignment and distance mapping between baseline and follow-up models. Aneurysm wall subdivisions were created based on saccular anatomy and flow-related characteristics, which were used to assess local hemodynamics. The distribution of growing regions across these subdivisions was then studied and stratified by aneurysm location and morphology to reveal distinct growth patterns. Statistical significance was evaluated using the Kruskal-Wallis and Mann-Whitney tests.
resultsGrowth predominantly occurred in the body (p < 0.0001) of aneurysms, with anterior communicating artery (ACom) (p < 0.0001) and lateral (p = 0.002) aneurysms showing a significantly greater tendency for growth in this region. In comparison, middle cerebral artery (MCA) (p < 0.0001) and bifurcation (p = 0.0001) aneurysms demonstrated growth in both the dome and the body. Notable differences in growth distribution across saccular regions included ACom versus MCA (neck, p = 0.038), bifurcation versus lateral (neck, p = 0.008), and so forth. The central flow region saw the most growth (p < 0.0001); although not significant, ACom (p = 0.196) and lateral (p = 0.218) aneurysms showed a tendency for growth in inflow and central zones, while MCA (p = 0.001) and bifurcation (p < 0.0001) aneurysms were more likely to grow in the central flow region.
conclusionsTwo primary mechanisms seem to influence aneurysm growth: high-flow impingement jets in the neck, body, and inflow zones leading to wall degeneration/thinning, mainly in ACom aneurysms; and slow, oscillatory flow conditions in the dome and central flow zones promoting wall remodeling/thickening, mainly in MCA aneurysms. This latter mechanism is also observed as secondary flows in ACom aneurysms. These findings emphasize the need to understand the distinct and sometimes concurrent mechanisms of aneurysm growth, advocating for targeted monitoring and interventions that mitigate rupture risks by considering the unique hemodynamic environments within different aneurysm regions and locations.
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