{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T12:05:09Z","timestamp":1794053109608,"version":"4.8.0"},"reference-count":143,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:p>Atherosclerosis and intracranial saccular aneurysms predictably localize in areas with complex arterial geometries such as bifurcations and curvatures. These sites are characterized by unique hemodynamic conditions that possibly influence the risk for these disorders. One hemodynamic parameter in particular has emerged as a key regulator of vascular biology\u2014wall shear stress (WSS). Variations in geometry can change the distribution and magnitude of WSS, thus influencing the risk for vascular disorders. Computer simulations conducted using patient-specific data have suggested that departures from normal levels of WSS lead to aneurysm formation and progression. In addition, multiple studies indicate that disturbed flow and low WSS predispose patients to extracranial atherosclerosis, and particularly to carotid artery disease. Conversely, in the case of intracranial atherosclerosis, more studies are needed to provide a firm link between hemodynamics and atherogenesis. The recognition of WSS as an important factor in cerebral vascular disease may help to identify individuals at risk and guide treatment options.<\/jats:p>","DOI":"10.3171\/2009.10.jns09759","type":"journal-article","created":{"date-parts":[[2009,11,28]],"date-time":"2009-11-28T02:57:02Z","timestamp":1259377022000},"page":"1240-1253","source":"Crossref","is-referenced-by-count":209,"title":["The critical role of hemodynamics in the development of cerebral vascular disease"],"prefix":"10.3171","volume":"112","author":[{"given":"Alexander M.","family":"Nixon","sequence":"first","affiliation":[{"name":"Departments of Vascular Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Murat","family":"Gunel","sequence":"additional","affiliation":[{"name":"Neurosurgery, Yale University School of Medicine, New Haven, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bauer E.","family":"Sumpio","sequence":"additional","affiliation":[{"name":"Departments of Vascular Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1121240","series-title":"Stroke","first-page":"2500","article-title":"Computation of hemodynamics in the circle of Willis","volume":"38","author":"Alnaes","year":"2007"},{"key":"b2-1121240","series-title":"Cell Mol Life Sci","first-page":"1078","article-title":"Endothelium-derived nitric oxide and vascular physiology and pathology","volume":"55","author":"Arnal","year":"1999"},{"key":"b3-1121240","series-title":"Neuroimaging Clin N Am","first-page":"709","article-title":"Magnetic resonance imaging of intracranial aneurysms","volume":"7","author":"Atlas","year":"1997"},{"key":"b4-1121240","series-title":"J Vasc Surg","first-page":"789","article-title":"Endothelial cell response to different mechanical forces","volume":"32","author":"Azuma","year":"2000"},{"key":"b5-1121240","series-title":"Kidney Int Suppl","first-page":"S100","article-title":"Shear stress and the endothelium","volume":"67","author":"Ballermann","year":"1998"},{"key":"b6-1121240","series-title":"Physiol Rev","first-page":"481","article-title":"eNOS activation by physical forces: from short-term regulation of contraction to chronic remodeling of cardiovascular tissues","volume":"89","author":"Balligand","year":"2009"},{"key":"b7-1121240","series-title":"Arch Neurol","first-page":"119","article-title":"Arteriographic study of cerebrovascular disease. 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