{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:26:09Z","timestamp":1792020369459,"version":"4.4.0"},"reference-count":15,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nPerianeurysmal edema (PAE) has been suggested as an indicator of potential aneurysm rupture; however, the hemodynamic features of these aneurysms are still unknown. A computational fluid dynamic (CFD) analysis was performed to evaluate the hemodynamic features of a very rare case of a ruptured middle cerebral artery (MCA) aneurysm with PAE.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 65-year-old woman presented with disturbed consciousness. A subarachnoid hemorrhage due to an azygos anterior cerebral artery (ACA) aneurysm rupture was suspected. An unruptured MCA aneurysm with PAE was identified in the left temporal lobe. Although the ACA aneurysm was clipped to prevent re-bleeding, the MCA aneurysm subsequently ruptured 6 days later. Clipping of the MCA aneurysm was performed, and hemosiderin deposits suggestive of sentinel bleeding were found on the surface of the aneurysm dome. CFD analysis revealed unstable hemodynamic stress at the expanded bleb area after rupture, localized to the rupture site. Moreover, this analysis revealed flow impingement with pressure elevation and low wall shear stress, which indicated increased inflammation and aneurysm wall thinning that likely led to rupture.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nHemosiderin deposits at the aneurysm wall and PAE indicates leakage from a cerebral aneurysm. Hemodynamic stress at the aneurysm may promote an inflammatory response and lead to wall weakening accompanied by PAE. Based on our findings, we recommend that surgical intervention should be considered as the first line of treatment for such aneurysms to prevent rupture.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_780_2020","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T08:01:23Z","timestamp":1612944083000},"page":"49","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Hemodynamic features of an intracranial aneurysm rupture predicted by perianeurysmal edema: A case report"],"prefix":"10.25259","volume":"12","author":[{"given":"Tomoaki","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitoshi","family":"Hasegawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Ando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Shibuya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jotaro","family":"On","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Oishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiko","family":"Fujii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"key":"10.25259\/SNI_780_2020\/ref-1","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1038\/jcbfm.2012.84","article-title":"Biology of intracranial aneurysms: Role of inflammation","volume":"32","author":"Chalouhi","year":"2012","journal-title":"J Cereb Blood Flow Metab"},{"key":"10.25259\/SNI_780_2020\/ref-2","doi-asserted-by":"crossref","first-page":"446","DOI":"10.3171\/2014.10.JNS141560","article-title":"Perianeurysmal edema in giant intracranial aneurysms in relation to aneurysm location, size, and partial thrombosis","volume":"123","author":"Dengler","year":"2015","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_780_2020\/ref-3","doi-asserted-by":"crossref","first-page":"E21","DOI":"10.3171\/2019.5.FOCUS19234","article-title":"Flow-induced, inflammation-mediated arterial wall remodeling in the formation and progression of intracranial aneurysms","volume":"47","author":"Fr\u00f6sen","year":"2019","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI_780_2020\/ref-4","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1016\/j.clineuro.2008.10.002","article-title":"Progressive perianeurysmal edema preceding the rupture of a small basilar artery aneurysm","volume":"111","author":"Hiu","year":"2009","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_780_2020\/ref-5","doi-asserted-by":"crossref","first-page":"1396","DOI":"10.1161\/01.STR.30.7.1396","article-title":"Structural fragility and inflammatory response of ruptured cerebral aneurysms. 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