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Physical Factors Effecting Cerebral Aneurysm Pathophysiology

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Abstract

Many factors that are either blood-, wall-, or hemodynamics-borne have been associated with the initiation, growth, and rupture of intracranial aneurysms. The distribution of cerebral aneurysms around the bifurcations of the circle of Willis has provided the impetus for numerous studies trying to link hemodynamic factors (flow impingement, pressure, and/or wall shear stress) to aneurysm pathophysiology. The focus of this review is to provide a broad overview of such hemodynamic associations as well as the subsumed aspects of vascular anatomy and wall structure. Hemodynamic factors seem to be correlated to the distribution of aneurysms on the intracranial arterial tree and complex, slow flow patterns seem to be associated with aneurysm growth and rupture. However, both the prevalence of aneurysms in the general population and the incidence of ruptures in the aneurysm population are extremely low. This suggests that hemodynamic factors and purely mechanical explanations by themselves may serve as necessary, but never as necessary and sufficient conditions of this disease’s causation. The ultimate cause is not yet known, but it is likely an additive or multiplicative effect of a handful of biochemical and biomechanical factors.

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Acknowledgments

This work was supported by NIH R01-NS045753 to B.B.L.

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Authors and Affiliations

  1. Department of Neurological Surgery, Stony Brook University Medical Center, 100 Nicolls Road, HSC T12, Room 080, Stony Brook, NY, 11794-8122, USA

    Chander Sadasivan, David J. Fiorella, Henry H. Woo & Baruch B. Lieber

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  1. Chander Sadasivan
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  2. David J. Fiorella
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  3. Henry H. Woo
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  4. Baruch B. Lieber
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Correspondence to Baruch B. Lieber.

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Associate Editor Ender A. Finol oversaw the review of this article.

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Sadasivan, C., Fiorella, D.J., Woo, H.H. et al. Physical Factors Effecting Cerebral Aneurysm Pathophysiology. Ann Biomed Eng 41, 1347–1365 (2013). https://doi.org/10.1007/s10439-013-0800-z

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  • DOI: https://doi.org/10.1007/s10439-013-0800-z

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