Aneurysm Formation, Growth, and Rupture: The Biology and Physics of Cerebral Aneurysms

World Neurosurg. 2019 Oct:130:277-284. doi: 10.1016/j.wneu.2019.07.093. Epub 2019 Jul 16.

Abstract

Cerebral aneurysms (CAs) are characterized by a pathological wall structure with internal elastic lamina and media disruption, which leads to focal weakened pouches of the arterial wall. The prevalence of unruptured CAs has been estimated to be 2%-5% in the general population. During the past few decades, the pathophysiological mechanisms behind the formation, growth, and rupture of CAs have been the focus of numerous research studies. In the present review, we have summarized the inflammatory pathways, genetics, and risk factors for the formation, growth, and rupture of CAs. In addition, we have discussed the concepts of geometric indexes, flow patterns, and fluid dynamics that govern CA development.

Keywords: Cerebral aneurysms; Flow dynamics; Inflammation; Intracranial aneurysms; Wall shear stress.

Publication types

  • Review

MeSH terms

  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / pathology*
  • Aneurysm, Ruptured / surgery
  • Cerebral Angiography / methods
  • Hemodynamics / physiology*
  • Humans
  • Imaging, Three-Dimensional / methods
  • Inflammation / complications
  • Inflammation / pathology*
  • Intracranial Aneurysm / diagnosis
  • Intracranial Aneurysm / pathology*
  • Intracranial Aneurysm / surgery