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Flow patterns inside the cerebral aneurysms affect aneurysm wall thickness.

Tatsuya Mori1, Hidehito Kimura2, Kosuke Hayashi3

  • 1Department of Neurosurgery, Kobe University Graduate School of Medicine, Kusunoki-cho 7-5-1, Chuo-ku, Kobe, 〒650-0017, Japan.

Neurosurgical Review
|October 17, 2025
PubMed
Summary
This summary is machine-generated.

Computational fluid dynamics parameters, wall shear stress vector direction variation (WSSDV) and oscillatory shear index (OSI), accurately predict cerebral aneurysm wall thinning and thickening. These findings offer new insights into aneurysm wall remodeling and potential rupture risk.

Keywords:
Computational fluid dynamicsIntracranial aneurysmOscillatory shear indexThick wallThin wallWall shear stress vector direction variation

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Area of Science:

  • Cerebrovascular diseases
  • Biomedical engineering
  • Fluid dynamics

Background:

  • Conventional imaging cannot determine cerebral aneurysm wall thickness.
  • Previous research suggested wall shear stress vector direction variation (WSSDV) and oscillatory shear index (OSI) may predict wall-thinning areas.
  • Distinct flow patterns are hypothesized to influence aneurysm wall remodeling.

Purpose of the Study:

  • To evaluate the positive predictive value (PPV) of WSSDV and OSI in identifying thin-walled and thick-walled regions of cerebral aneurysms.
  • To correlate computational fluid dynamics (CFD) findings with intraoperative observations.
  • To propose a link between specific flow patterns and aneurysm wall thinning or thickening.

Main Methods:

  • Preoperative CFD analysis was performed on 42 unruptured intracranial aneurysms (UIAs).
  • WSSDV and OSI color maps were generated to predict thin-walled regions (TIWRs) and thick-walled regions (TKWRs).
  • Intraoperative photographs were used to identify actual TIWRs (aTIWRs) and actual TKWRs (aTKWRs) for comparison.

Main Results:

  • WSSDV showed a PPV of 85% for aTIWRs and 79% for aTKWRs.
  • OSI demonstrated a PPV of 85% for aTIWRs and 67% for aTKWRs.
  • A strong correlation (Spearman's ρ = 0.849, p < 0.001) was found between WSSDV and OSI, reflecting changes in wall shear stress during the cardiac cycle.

Conclusions:

  • WSSDV and OSI are valuable parameters for predicting cerebral aneurysm wall thinning and thickening.
  • Parallel/divergent flows are associated with wall thinning, while rotational/convergent flows correlate with wall thickening.
  • These CFD-derived parameters enhance understanding of aneurysm wall remodeling mechanisms.