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Unruptured intracranial aneurysms: relation between morphology and wall strength
Leszek Lombarski1, Przemysław Kunert2, Sylwia Tarka3
1Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
Neurologia I Neurochirurgia Polska
|July 26, 2022
Summary
Increased dome dimension in small unruptured saccular intracranial aneurysms (sIAs) indicates lower wall strength and higher rupture risk. This morphological feature is more predictive than other parameters for assessing sIA rupture potential.
Area of Science:
- Neurosurgery
- Biomedical Engineering
- Pathology
Background:
- Subarachnoid hemorrhage from saccular intracranial aneurysm (sIA) rupture leads to high mortality.
- Understanding sIA morphology and biomechanics can identify rupture risk factors.
Purpose of the Study:
- To identify morphological differences between small unruptured sIAs with high and low wall strength (WS).
- To correlate morphological features with the risk of sIA rupture.
Main Methods:
- Eight unruptured sIAs from post mortem examinations were analyzed.
- Morphological parameters (dimensions, AR, SR, HW, BNF, shape) were assessed.
- Specimens underwent quasi-static pressure testing to determine rupture point.
Main Results:
- Three sIAs ruptured at significantly lower pressure (769 mmHg) compared to adjacent artery ruptures (1,259 mmHg).
- Low WS sIAs exhibited significantly larger dome dimensions than high WS sIAs.
- No significant differences in AR, SR, HW, BNF, or shape were found between WS groups.
Conclusions:
- Dome dimension is the sole morphological feature differentiating sIA wall strength.
- Increased dome dimension correlates with a higher risk of sIA rupture.
- Dome dimension may be a more reliable predictor of rupture risk than other morphometric parameters.
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