Section 2 Pathophysiology

*New Insight into Cerebrovascular Diseases - An Updated Comprehensive Review*

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**Chapter 2**

**Abstract**

computational fluid dynamics

**1. Introduction**

Hemodynamics in Ruptured

*Alena Sejkorová, Radovnický Tomáš, Hron Jaroslav,* 

*Beneš Vladimír, Dragomir-Daescu Dan and Sameš Martin*

Incidental detection of unruptured intracranial aneurysms (UIA) has increased in the recent years. There is a need in the clinical community to identify those that are prone to rupture and would require preventive treatment. Hemodynamics in cerebral blood vessels plays a key role in the lifetime cycle of intracranial aneurysms (IA). Understanding their initiation, growth, and rupture or stabilization may identify those hemodynamic features that lead to aneurysm instability and rupture. Modeling hemodynamics using computational fluid dynamics (CFD) could aid in understanding the processes in the development of IA. The neurosurgical approach during operation of IA allows direct visualization of the aneurysm sac and its sampling in many cases. Detailed analysis of the quality of the aneurysm wall under the microscope, together with histological assessment of the aneurysm wall and CFD modeling, can help in building complex knowledge on the relationship between the biology of the wall and hemodynamics. Detailed CFD analysis of the rupture point can further strengthen the association between hemodynamics and rupture. In this chapter we summarize current knowledge on CFD and intracranial aneurysms.

**Keywords:** intracranial aneurysm, hemodynamics, rupture, cerebral blood flow,

Intracranial aneurysm (IA), a pathological dilation of the vessel wall, is the result of hemodynamic forces on the wall of the intracranial artery. It is characterized by mild to moderate structural changes of the vessel wall, which may result in

In the last 15 years, there has been increasing incidental detection of unruptured intracranial aneurysms (UIA) due to an increasing use of noninvasive radiological examinations, such as computed tomography angiography (CTA) and magnetic resonance angiography (MRA) [2]. The increasing use of these noninvasive techniques for various non-specific complaints results in higher detection and increasing treatment of UIA. While 20% of individuals operated on for an IA in 1998 were carrying a UIA, in more recent years, the number has increased to more than 50% of all patients operated on for IA in the Department of Neurosurgery of

aneurysm rupture, leading to a severe form of hemorrhagic stroke [1].

*Feletti Alberto, Koblížek Miroslav, Zámečník Josef,* 

Intracranial Aneurysms

*Hejčl Aleš, Stratilová Mária, Švihlová Helena,* 
