Computing the difference between life and death: Prerupture blood flow analysis of a fatal aneurysm bleed

Although hemodynamics plays a key role in the genesis, expansion, and rupture of an aneurysm, quantified hemodynamic parameters for comparison have not been standardized for predicting the risk of rupture of intracranial aneurysms. Computational fluid dynamics is being increasingly used in near-realistic, patient-specific simulation of blood flow in intracranial aneurysms. A simulation was carried out on the computed tomography (CT) angiogram image of a patient harboring a giant internal carotid artery aneurysm. Since the CT angiogram was performed a few hours before the fatal rupture of the aneurysm, the study could give an insight into the hemodynamics of the aneurysm that tipped it to rupture. Wall shear stress, pressure distribution, and flow streamlines were obtained using computational methods. These objective results could form the basis of reference for future studies employing simulation techniques for predicting aneurysmal rupture.