{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:27:52Z","timestamp":1787984872261,"version":"build-2784847793"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2013,7]]},"abstract":"\nObject<\/jats:title>\nWall shear stress (WSS) plays a role in regulating endothelial function and has been suspected in cerebral aneurysm rupture. The aim of this study was to evaluate the spatial relationship between localized thinning of the aneurysm dome and estimated hemodynamic factors, hypothesizing that a low WSS would correlate with aneurysm wall degeneration.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nSteady-state computational fluid dynamics analysis was performed on 16 aneurysms in 14 patients based on rotational angiographic volumes to derive maps of WSS, its spatial gradient (WSSG), and pressure. Local dome thickness was estimated categorically based on tissue translucency from high-resolution intraoperative microscopy findings. Each computational model was oriented to match the corresponding intraoperative view and numerically sampled in thin and normal adjacent dome regions, with controls at the neck and parent vessel. The pressure differential was computed as the difference between aneurysm dome points and the mean neck pressure. Pulsatile time-dependent confirmatory analysis was carried out in 7 patients.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nMatched-pair analysis revealed significantly lower levels of WSS (0.381 Pa vs 0.816 Pa; p < 0.0001) in thin-walled dome areas than in adjacent baseline thickness regions. Similarly, log WSSG and log WSS \u00d7 WSSG were both lower in thin regions (both p < 0.0001); multivariate logistic regression analysis identified lower WSS and higher pressure differential as independent correlates of lower wall thickness with an area under the curve of 0.80. This relationship was observed in both steady-state and time-dependent pulsatile analyses.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nThin-walled regions of unruptured cerebral aneurysms colocalize with low WSS, suggesting a cellular mechanotransduction link between areas of flow stasis and aneurysm wall thinning.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2013.2.jns12968","type":"journal-article","created":{"date-parts":[[2013,3,29]],"date-time":"2013-03-29T14:01:23Z","timestamp":1364565683000},"page":"172-179","source":"Crossref","is-referenced-by-count":70,"title":["Colocalization of thin-walled dome regions with low hemodynamic wall shear stress in unruptured cerebral aneurysms"],"prefix":"10.3171","volume":"119","author":[{"given":"Laith M.","family":"Kadasi","sequence":"first","affiliation":[{"name":"Cerebrovascular and Endovascular Division, Department of Neurosurgery, Tufts Medical Center; and"},{"name":"Tufts University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter C.","family":"Dent","sequence":"additional","affiliation":[{"name":"Cerebrovascular and Endovascular Division, Department of Neurosurgery, Tufts Medical Center; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel M.","family":"Malek","sequence":"additional","affiliation":[{"name":"Cerebrovascular and Endovascular Division, Department of Neurosurgery, Tufts Medical Center; and"},{"name":"Tufts University School of Medicine, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns12968","series-title":"AJNR Am J Neuroradiol","first-page":"1309","article-title":"Histologic and morphologic comparison of experimental aneurysms with human intracranial aneurysms","volume":"19","author":"Abruzzo","year":"1998"},{"key":"b2-jns12968","series-title":"Acta Med Okayama","first-page":"257","article-title":"Growth and rupture of unruptured cerebral aneurysms based on the intraoperative appearance","volume":"48","author":"Asari","year":"1994"},{"key":"b3-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1423","DOI":"10.1161\/STROKEAHA.109.570770","article-title":"Aneurysm inflow-angle as a discriminant for rupture in sidewall cerebral aneurysms: morphometric and computational fluid dynamic analysis","volume":"41","author":"Baharoglu","year":"2010"},{"key":"b4-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2997","DOI":"10.1161\/STROKEAHA.108.521617","article-title":"Aneurysm growth occurs at region of low wall shear stress: patient-specific correlation of hemodynamics and growth in a longitudinal study","volume":"39","author":"Boussel","year":"2008"},{"key":"b5-jns12968","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"297","DOI":"10.3174\/ajnr.A1323","article-title":"Hemodynamic patterns of anterior communicating artery aneurysms: a possible association with rupture","volume":"30","author":"Castro","year":"2009"},{"key":"b6-jns12968","series-title":"AJNR Am J Neuroradiol","first-page":"2550","article-title":"Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models","volume":"26","author":"Cebral","year":"2005"},{"key":"b7-jns12968","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"264","DOI":"10.3174\/ajnr.A2274","article-title":"Association of hemodynamic characteristics and cerebral aneurysm rupture","volume":"32","author":"Cebral","year":"2011"},{"key":"b8-jns12968","series-title":"Circ Res","doi-asserted-by":"publisher","first-page":"532","DOI":"10.1161\/01.RES.82.5.532","article-title":"Oscillatory shear stress stimulates adhesion molecule expression in cultured human endothelium","volume":"82","author":"Chappell","year":"1998"},{"key":"b9-jns12968","series-title":"Am J Physiol Heart Circ Physiol","doi-asserted-by":"publisher","first-page":"H1209","DOI":"10.1152\/ajpheart.01047.2006","article-title":"Mechanotransduction and endothelial cell homeostasis: the wisdom of the cell","volume":"292","author":"Chien","year":"2007"},{"key":"b10-jns12968","series-title":"Circ Res","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1161\/01.RES.81.3.328","article-title":"Effects of changes in blood flow rate on cell death and cell proliferation in carotid arteries of immature rabbits","volume":"81","author":"Cho","year":"1997"},{"key":"b11-jns12968","series-title":"Proc Natl Acad Sci U S A","doi-asserted-by":"publisher","first-page":"14871","DOI":"10.1073\/pnas.0406073101","article-title":"Distinct endothelial phenotypes evoked by arterial waveforms derived from atherosclerosis-susceptible and -resistant regions of human vasculature","volume":"101","author":"Dai","year":"2004"},{"key":"b12-jns12968","series-title":"Circ Res","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1161\/01.RES.82.10.1094","article-title":"Oscillatory and steady laminar shear stress differentially affect human endothelial redox state: role of a superoxide-producing NADH oxidase","volume":"82","author":"De Keulenaer","year":"1998"},{"key":"b13-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2287","DOI":"10.1161\/01.STR.0000140636.30204.da","article-title":"Remodeling of saccular cerebral artery aneurysm wall is associated with rupture: histological analysis of 24 unruptured and 42 ruptured cases","volume":"35","author":"Fr\u00f6sen","year":"2004"},{"key":"b14-jns12968","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"662","DOI":"10.3171\/jns.2005.103.4.0662","article-title":"A proposed parent vessel geometry-based categorization of saccular intracranial aneurysms: computational flow dynamics analysis of the risk factors for lesion rupture","volume":"103","author":"Hassan","year":"2005"},{"key":"b15-jns12968","series-title":"AJNR Am J Neuroradiol","first-page":"1366","article-title":"CT angiography with electrocardiographically gated reconstruction for visualizing pulsation of intracranial aneurysms: identification of aneurysmal protuberance presumably associated with wall thinning","volume":"26","author":"Hayakawa","year":"2005"},{"key":"b16-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"660","DOI":"10.1161\/01.STR.28.3.660","article-title":"Case-fatality rates and functional outcome after subarachnoid hemorrhage: a systematic review","volume":"28","author":"Hop","year":"1997"},{"key":"b17-jns12968","series-title":"AJNR Am J Neuroradiol","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.3174\/ajnr.A1180","article-title":"Wall shear stress on ruptured and unruptured intracranial aneurysms at the internal carotid artery","volume":"29","author":"Jou","year":"2008"},{"key":"b18-jns12968","series-title":"J Neurointervent Surg","article-title":"Cerebral aneurysm wall thickness analysis using intraoperative microscopy: effect of size and gender on thin translucent regions","author":"Kadasi","year":"2012"},{"key":"b19-jns12968","series-title":"J Vasc Res","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1159\/000324840","article-title":"Cellular and molecular responses of the basilar terminus to hemodynamics during intracranial aneurysm initiation in a rabbit model","volume":"48","author":"Kolega","year":"2011"},{"key":"b20-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1161\/01.STR.29.1.181","article-title":"Apoptosis of medial smooth muscle cells in the development of saccular cerebral aneurysms in rats","volume":"29","author":"Kondo","year":"1998"},{"key":"b21-jns12968","series-title":"Circ Res","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1161\/01.RES.79.1.45","article-title":"Acute reductions in blood flow and shear stress induce platelet-derived growth factor-A expression in baboon prosthetic grafts","volume":"79","author":"Kraiss","year":"1996"},{"key":"b22-jns12968","series-title":"Gend Med","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.genm.2010.03.003","article-title":"Sex differences in intracranial arterial bifurcations","volume":"7","author":"Lindekleiv","year":"2010"},{"key":"b23-jns12968","series-title":"JAMA","doi-asserted-by":"publisher","first-page":"2035","DOI":"10.1001\/jama.282.21.2035","article-title":"Hemodynamic shear stress and its role in atherosclerosis","volume":"282","author":"Malek","year":"1999"},{"key":"b24-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1924","DOI":"10.1161\/STROKEAHA.106.481234","article-title":"Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation","volume":"38","author":"Meng","year":"2007"},{"key":"b25-jns12968","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1007\/BF01411286","article-title":"Types of unruptured cerebral aneurysms reviewed from operation video-recordings","volume":"138","author":"Mizoi","year":"1996"},{"key":"b26-jns12968","series-title":"Lancet","first-page":"809","article-title":"International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion","volume":"366","author":"Molyneux","year":"2005"},{"key":"b27-jns12968","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.3171\/2009.10.JNS09759","article-title":"The critical role of hemodynamics in the development of cerebral vascular disease. A review","volume":"112","author":"Nixon","year":"2010"},{"key":"b28-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"1531","DOI":"10.1161\/01.STR.29.8.1531","article-title":"Mortality and morbidity of surgery for unruptured intracranial aneurysms: a meta-analysis","volume":"29","author":"Raaymakers","year":"1998"},{"key":"b29-jns12968","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1227\/01.NEU.0000298914.32248.DC","article-title":"Prediction of complex flow patterns in intracranial atherosclerotic disease using computational fluid dynamics","volume":"61","author":"Schirmer","year":"2007"},{"key":"b30-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"2500","DOI":"10.1161\/01.STR.0000144648.89172.0f","article-title":"Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms","volume":"35","author":"Shojima","year":"2004"},{"key":"b31-jns12968","series-title":"Arterioscler Thromb Vasc Biol","doi-asserted-by":"publisher","first-page":"3102","DOI":"10.1161\/01.ATV.17.11.3102","article-title":"Shear stress gradients remodel endothelial monolayers in vitro via a cell proliferation-migration-loss cycle","volume":"17","author":"Tardy","year":"1997"},{"key":"b32-jns12968","series-title":"Am J Physiol Heart Circ Physiol","doi-asserted-by":"publisher","first-page":"H1380","DOI":"10.1152\/ajpheart.2001.281.3.H1380","article-title":"Shear level influences resistance artery remodeling: wall dimensions, cell density, and eNOS expression","volume":"281","author":"Tuttle","year":"2001"},{"key":"b33-jns12968","series-title":"Brain","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1093\/brain\/124.2.249","article-title":"Subarachnoid haemorrhage: diagnosis, causes and management","volume":"124","author":"van Gijn","year":"2001"},{"key":"b34-jns12968","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1227\/01.NEU.0000343541.85713.01","article-title":"Molecular alterations associated with aneurysmal remodeling are localized in the high hemodynamic stress region of a created carotid bifurcation","volume":"65","author":"Wang","year":"2009"},{"key":"b35-jns12968","series-title":"Lancet","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/S0140-6736(03)13860-3","article-title":"Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment","volume":"362","author":"Wiebers","year":"2003"},{"key":"b36-jns12968","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1161\/STROKEAHA.110.592923","article-title":"Hemodynamic-morphologic discriminants for intracranial aneurysm rupture","volume":"42","author":"Xiang","year":"2011"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/119\/1\/article-p172.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/119\/1\/article-p172.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/119\/1\/article-p172.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,14]],"date-time":"2022-08-14T17:18:17Z","timestamp":1660497497000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/119\/1\/article-p172.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2013,7]]},"references-count":36,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2013.2.jns12968","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7]]}}}