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A Low Mortality Rat Model to Assess Delayed Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage
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Role of Computational Fluid Dynamics for Predicting Delayed Cerebral Ischemia After Aneurysmal Subarachnoid

Masato Shiba1, Fujimaro Ishida2, Fumitaka Miya3

  • 1Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan. mshiba@clin.medic.mie-u.ac.jp.

Acta Neurochirurgica. Supplement
|August 14, 2019
PubMed

Insights

Computational fluid dynamics (CFD) may predict delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). This prospective study investigates CFD hemodynamic features to identify patients at risk for DCI and poor outcomes.

Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Computational Fluid Dynamics

Background:

  • Delayed cerebral ischemia (DCI) is a major complication following aneurysmal subarachnoid hemorrhage (SAH), leading to significant morbidity and mortality.
  • Previous retrospective studies suggest computational fluid dynamics (CFD) can predict DCI by analyzing arterial dimensions and blood flow velocity.

Purpose of the Study:

  • To prospectively validate CFD as a predictive tool for DCI in patients with aneurysmal SAH.
  • To investigate hemodynamic features of cerebral arteries in the acute phase of SAH using CFD.
  • To correlate CFD findings with the occurrence of DCI, cerebral vasospasm, cerebral infarction, and long-term functional outcomes.

Main Methods:

  • Multicenter prospective cohort study design.
  • Patients with aneurysmal SAH will undergo CFD analysis utilizing preoperative 3D computed tomography angiography.
  • Primary outcome: CFD features in patients who develop DCI. Secondary outcomes: CFD features associated with vasospasm, infarction, and modified Rankin Scale scores at 3 months.

Main Results:

  • Data collection and analysis are ongoing as part of a prospective study.
  • The study aims to identify specific CFD parameters indicative of DCI risk.
  • Results will elucidate the relationship between acute hemodynamic profiles and subsequent ischemic events.

Conclusions:

  • This multicenter prospective study protocol is designed to establish a novel diagnostic method for predicting DCI.
  • The findings are expected to enable early identification of high-risk patients before aneurysmal obliteration.
  • Predictive CFD analysis could improve patient management and outcomes after aneurysmal SAH.
Abstract

Keywords:
Cerebral aneurysmComputational fluid dynamicsComputed tomography angiographyDelayed cerebral ischemiaSubarachnoid hemorrhage

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