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Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review

Intracranial aneurysms (IAs) carry the risk of rupture, which will lead to subarachnoid hemorrhage, which has a high mortality and morbidity risk. However, the treatment of IA's carries mortality and morbidity risks too. There are well-known risk factors for the rupture of IAs like age, size, a...

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Autores principales: Jirjees, Srood, Htun, Zin Mar, Aldawudi, Israa, Katwal, Prakash C, Khan, Safeera
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425825/
https://www.ncbi.nlm.nih.gov/pubmed/32802613
http://dx.doi.org/10.7759/cureus.9178
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author Jirjees, Srood
Htun, Zin Mar
Aldawudi, Israa
Katwal, Prakash C
Khan, Safeera
author_facet Jirjees, Srood
Htun, Zin Mar
Aldawudi, Israa
Katwal, Prakash C
Khan, Safeera
author_sort Jirjees, Srood
collection PubMed
description Intracranial aneurysms (IAs) carry the risk of rupture, which will lead to subarachnoid hemorrhage, which has a high mortality and morbidity risk. However, the treatment of IA's carries mortality and morbidity risks too. There are well-known risk factors for the rupture of IAs like age, size, and site. However, choosing patients with unruptured IAs for treatment is still a big challenge. This review article aimed to find out the relationship between morphological and hemodynamic characters of IAs with their rupture and incorporate these factors with well-known factors to yield an accurate module for predicting the rupture of IAs and decision-making in the treatment of unruptured IAs. We searched in PubMed and Medline databases by using the following keywords: IAs, subarachnoid hemorrhage, and risk of rupture, morphology, and hemodynamic “mesh.” A total of 19 studies with 7269 patients and 9167 IAs, of which 1701 had ruptured, were reviewed thoroughly. Some modules like population, hypertension, age, size, earlier subarachnoid hemorrhage, and site (PHASES) score that involve well-known risk factors can be used to assess the risk of rupture of IAs. However, decision making for treating unruptured IA needs more detailed and more accurate modules. Studying morphological and hemodynamic factors and incorporation of them with well-known risk factors to yield a more comprehensive module will be very helpful in treating unruptured IA. Among morphological factors, aspect ratio (AR), size ratio (SR), aneurysm height, and bottle-neck factor showed significant effects on the growth and rupture of IA. Besides, wall shear stress (WSS), oscillatory shear index (OSI), and low wall shear stress area (LSA) as hemodynamic factors could have a substantial impact on the formation, shape, growth, and rupture of unruptured IA.
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spelling pubmed-74258252020-08-14 Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review Jirjees, Srood Htun, Zin Mar Aldawudi, Israa Katwal, Prakash C Khan, Safeera Cureus Neurology Intracranial aneurysms (IAs) carry the risk of rupture, which will lead to subarachnoid hemorrhage, which has a high mortality and morbidity risk. However, the treatment of IA's carries mortality and morbidity risks too. There are well-known risk factors for the rupture of IAs like age, size, and site. However, choosing patients with unruptured IAs for treatment is still a big challenge. This review article aimed to find out the relationship between morphological and hemodynamic characters of IAs with their rupture and incorporate these factors with well-known factors to yield an accurate module for predicting the rupture of IAs and decision-making in the treatment of unruptured IAs. We searched in PubMed and Medline databases by using the following keywords: IAs, subarachnoid hemorrhage, and risk of rupture, morphology, and hemodynamic “mesh.” A total of 19 studies with 7269 patients and 9167 IAs, of which 1701 had ruptured, were reviewed thoroughly. Some modules like population, hypertension, age, size, earlier subarachnoid hemorrhage, and site (PHASES) score that involve well-known risk factors can be used to assess the risk of rupture of IAs. However, decision making for treating unruptured IA needs more detailed and more accurate modules. Studying morphological and hemodynamic factors and incorporation of them with well-known risk factors to yield a more comprehensive module will be very helpful in treating unruptured IA. Among morphological factors, aspect ratio (AR), size ratio (SR), aneurysm height, and bottle-neck factor showed significant effects on the growth and rupture of IA. Besides, wall shear stress (WSS), oscillatory shear index (OSI), and low wall shear stress area (LSA) as hemodynamic factors could have a substantial impact on the formation, shape, growth, and rupture of unruptured IA. Cureus 2020-07-14 /pmc/articles/PMC7425825/ /pubmed/32802613 http://dx.doi.org/10.7759/cureus.9178 Text en Copyright © 2020, Jirjees et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Jirjees, Srood
Htun, Zin Mar
Aldawudi, Israa
Katwal, Prakash C
Khan, Safeera
Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review
title Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review
title_full Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review
title_fullStr Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review
title_full_unstemmed Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review
title_short Role of Morphological and Hemodynamic Factors in Predicting Intracranial Aneurysm Rupture: A Review
title_sort role of morphological and hemodynamic factors in predicting intracranial aneurysm rupture: a review
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425825/
https://www.ncbi.nlm.nih.gov/pubmed/32802613
http://dx.doi.org/10.7759/cureus.9178
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