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Research ArticleNeurointervention
Open Access

Hemodynamics of Cerebral Aneurysm Initiation: The Role of Wall Shear Stress and Spatial Wall Shear Stress Gradient

Z. Kulcsár, Á. Ugron, M. Marosfői, Z. Berentei, G. Paál and I. Szikora
American Journal of Neuroradiology March 2011, 32 (3) 587-594; DOI: https://doi.org/10.3174/ajnr.A2339
Z. Kulcsár
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Á. Ugron
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M. Marosfői
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Z. Berentei
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G. Paál
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I. Szikora
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    Fig 1.

    A, Basilar artery. Posteroanterior Townes view DSA of patient 1 shows no aneurysm at the basilar bifurcation. B, Surface pressure (left) and WSS distribution map (right) demonstrate significant forces attacking the basilar tip. C, Along the arbitrarily defined line, the diagram shows a major peak in SWSSG at point 5 (thin arrow), followed immediately by a WSS peak (thick arrow). D, This point corresponds to the proximal edge of the later developed aneurysm neck as shown by the time-of-flight MRA (arrow indicates the future aneurysm site on A, B, C, and the developed aneurysm on D).

  • Fig 2.
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    Fig 2.

    A, Right ICA lateral view DSA of patient 2 shows no aneurysm at the upper wall of the C2 ICA segment (arrow). B, Surface pressure (upper) and WSS distribution map (lower) demonstrate increased forces at the site of future aneurysm. C, Along the arbitrarily defined line, the diagram shows a major peak in SWSSG approximately at point 3 (thin arrow), followed immediately by a WSS peak at point 5 (thick arrow). D, The first combined peak is followed by a second at approximately points 7–8, which fell later into the neck area of the developed aneurysm, as seen on the 3D reconstructed angiogram.

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    Fig 3.

    A and B, Surface pressure (A) and WSS (B) distribution maps of the aneurysm of patient 2. C, Velocity vectors of the same aneurysm show a simple flow pattern without a well definable impingement zone.

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    Fig 4.

    A and B, Lateral view DSA of the right ICA of patient 3 shows an aneurysm at the carotid cave; however, no aneurysm beginning is visible at the origin of the PcomA (A), demonstrated by the 3D reconstruction angiogram (arrows, B). C, Surface pressure (upper) and WSS distribution map (lower) demonstrate increased forces at the edges of the tiny aneurysm beginning (arrows). D, Along the arbitrarily defined line, the diagram shows a first major peak in SWSSG approximately after point 3, followed immediately by a lower WSS peak and again at points 6 and 7 respectively (thick arrow). E, These points correspond to the proximal and distal edges of the aneurysm beginning, which further evolved to a larger aneurysm that ruptured (arrow).

  • Fig 5.
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    Fig 5.

    A and B, Surface pressure (A) and WSS distribution (B) on the aneurysm wall of patient 3. C, The velocity vector fields show a changing impingement zone at the aneurysm dome throughout the cardiac cycle and changing multiple vortices in the aneurysm lumen.

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American Journal of Neuroradiology: 32 (3)
American Journal of Neuroradiology
Vol. 32, Issue 3
1 Mar 2011
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Cite this article
Z. Kulcsár, Á. Ugron, M. Marosfői, Z. Berentei, G. Paál, I. Szikora
Hemodynamics of Cerebral Aneurysm Initiation: The Role of Wall Shear Stress and Spatial Wall Shear Stress Gradient
American Journal of Neuroradiology Mar 2011, 32 (3) 587-594; DOI: 10.3174/ajnr.A2339

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Hemodynamics of Cerebral Aneurysm Initiation: The Role of Wall Shear Stress and Spatial Wall Shear Stress Gradient
Z. Kulcsár, Á. Ugron, M. Marosfői, Z. Berentei, G. Paál, I. Szikora
American Journal of Neuroradiology Mar 2011, 32 (3) 587-594; DOI: 10.3174/ajnr.A2339
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