{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T18:56:14Z","timestamp":1789671374069,"version":"4.0.1"},"reference-count":56,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The complex mix of factors, including hemodynamic forces and wall remodeling mechanisms, that drive intracranial aneurysm growth is unclear. This study focuses on the specific regions within aneurysm walls where growth occurs and their relationship to the prevalent hemodynamic conditions to reveal critical mechanisms leading to enlargement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors examined hemodynamic models of 67 longitudinally followed aneurysms, identifying 88 growth regions. These regions (of enlargement) were pinpointed through alignment and distance mapping between baseline and follow-up models. Aneurysm wall subdivisions were created based on saccular anatomy and flow-related characteristics, which were used to assess local hemodynamics. The distribution of growing regions across these subdivisions was then studied and stratified by aneurysm location and morphology to reveal distinct growth patterns. Statistical significance was evaluated using the Kruskal-Wallis and Mann-Whitney tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Growth predominantly occurred in the body (p &lt; 0.0001) of aneurysms, with anterior communicating artery (ACom) (p &lt; 0.0001) and lateral (p = 0.002) aneurysms showing a significantly greater tendency for growth in this region. In comparison, middle cerebral artery (MCA) (p &lt; 0.0001) and bifurcation (p = 0.0001) aneurysms demonstrated growth in both the dome and the body. Notable differences in growth distribution across saccular regions included ACom versus MCA (neck, p = 0.038), bifurcation versus lateral (neck, p = 0.008), and so forth. The central flow region saw the most growth (p &lt; 0.0001); although not significant, ACom (p = 0.196) and lateral (p = 0.218) aneurysms showed a tendency for growth in inflow and central zones, while MCA (p = 0.001) and bifurcation (p &lt; 0.0001) aneurysms were more likely to grow in the central flow region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Two primary mechanisms seem to influence aneurysm growth: high-flow impingement jets in the neck, body, and inflow zones leading to wall degeneration\/thinning, mainly in ACom aneurysms; and slow, oscillatory flow conditions in the dome and central flow zones promoting wall remodeling\/thickening, mainly in MCA aneurysms. This latter mechanism is also observed as secondary flows in ACom aneurysms. These findings emphasize the need to understand the distinct and sometimes concurrent mechanisms of aneurysm growth, advocating for targeted monitoring and interventions that mitigate rupture risks by considering the unique hemodynamic environments within different aneurysm regions and locations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.9.jns241208","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T20:27:44Z","timestamp":1737750464000},"page":"1741-1750","source":"Crossref","is-referenced-by-count":9,"title":["Competing pathways of intracranial aneurysm growth: linking regional growth distribution and hemodynamics"],"prefix":"10.3171","volume":"142","author":[{"given":"Yogesh","family":"Karnam","sequence":"first","affiliation":[{"name":"Department of Bioengineering, George Mason University, Fairfax, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Mut","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, George Mason University, Fairfax, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M.","family":"Robertson","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, University of California, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan R.","family":"Cebral","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, George Mason University, Fairfax, Virginia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"AJNR Am J Neuroradiol","first-page":"615","article-title":"Risk factors for growth of intracranial aneurysms: a systematic review and meta-analysis","volume":"37","author":"Brinjikji W","year":"2016","unstructured":"Brinjikji W, Zhu YQ, Lanzino G,  Risk factors for growth of intracranial aneurysms: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2016;37(4):615\u2013620."},{"issue":"1","key":"b2","series-title":"Radiology","first-page":"258","article-title":"Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors","volume":"269","author":"Villablanca JP","year":"2013","unstructured":"Villablanca JP, Duckwiler GR, Jahan R,  Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors. Radiology. 2013;269(1):258\u2013265."},{"key":"b3","series-title":"World Neurosurg","first-page":"e425","article-title":"PHASES and ELAPSS scores are associated with aneurysm growth: a study of 431 unruptured intracranial aneurysms","volume":"114","author":"Brinjikji W","year":"2018","unstructured":"Brinjikji W, Pereira VM, Khumtong R,  PHASES and ELAPSS scores are associated with aneurysm growth: a study of 431 unruptured intracranial aneurysms. World Neurosurg. 2018;114:e425\u2013e432."},{"issue":"4","key":"b4","series-title":"J Neurointerv Surg","first-page":"407","article-title":"Hemodynamics in growing and stable cerebral aneurysms","volume":"8","author":"Sforza DM","year":"2016","unstructured":"Sforza DM, Kono K, Tateshima S, Vi\u00f1uela F, Putman C, Cebral JR. Hemodynamics in growing and stable cerebral aneurysms. J Neurointerv Surg. 2016;8(4):407\u2013412."},{"issue":"4","key":"b5","series-title":"Brain Sci","first-page":"520","article-title":"Morphological and hemodynamic changes during cerebral aneurysm growth","volume":"11","author":"Nordahl ER","year":"2021","unstructured":"Nordahl ER, Uthamaraj S, Dennis KD,  Morphological and hemodynamic changes during cerebral aneurysm growth. Brain Sci. 2021;11(4):520."},{"issue":"12","key":"b6","series-title":"AJNR Am J Neuroradiol","first-page":"2102","article-title":"Comparing morphology and hemodynamics of stable-versus-growing and grown intracranial aneurysms","volume":"40","author":"Leemans EL","year":"2019","unstructured":"Leemans EL, Cornelissen BMW, Slump CH, Majoie CBLM, Cebral JR, Marquering HA. Comparing morphology and hemodynamics of stable-versus-growing and grown intracranial aneurysms. AJNR Am J Neuroradiol. 2019;40(12):2102\u20132110."},{"issue":"6","key":"b7","series-title":"Stroke","first-page":"1924","article-title":"Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation","volume":"38","author":"Meng H","year":"2007","unstructured":"Meng H, Wang Z, Hoi Y,  Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation. Stroke. 2007;38(6):1924\u20131931."},{"issue":"21","key":"b8","series-title":"JAMA","first-page":"2035","article-title":"Hemodynamic shear stress and its role in atherosclerosis","volume":"282","author":"Malek AM","year":"1999","unstructured":"Malek AM, Alper SL, Izumo S. Hemodynamic shear stress and its role in atherosclerosis. JAMA. 1999;282(21):2035\u20132042."},{"issue":"11","key":"b9","series-title":"Stroke","first-page":"2500","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 M","year":"2004","unstructured":"Shojima M, Oshima M, Takagi K,  Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms. Stroke. 2004;35(11):2500\u20132505."},{"issue":"21","key":"b10","series-title":"Comput Struc","first-page":"1326","article-title":"Blood flow dynamics and arterial wall interaction in a saccular aneurysm model of the basilar artery","volume":"84","author":"Valencia A","year":"2006","unstructured":"Valencia A, Solis F. Blood flow dynamics and arterial wall interaction in a saccular aneurysm model of the basilar artery. Comput Struc. 2006;84(21):1326\u20131337."},{"issue":"8","key":"b11","series-title":"Stroke","first-page":"1774","article-title":"Characterization of critical hemodynamics contributing to aneurysmal remodeling at the basilar terminus in a rabbit model","volume":"41","author":"Metaxa E","year":"2010","unstructured":"Metaxa E, Tremmel M, Natarajan SK,  Characterization of critical hemodynamics contributing to aneurysmal remodeling at the basilar terminus in a rabbit model. Stroke. 2010;41(8):1774\u20131782."},{"issue":"4","key":"b12","series-title":"Stroke","first-page":"951","article-title":"Patient- and aneurysm-specific risk factors for intracranial aneurysm growth: a systematic review and meta-analysis","volume":"47","author":"Backes D","year":"2016","unstructured":"Backes D, Rinkel GJE, Laban KG, Algra A, Vergouwen MDI. Patient- and aneurysm-specific risk factors for intracranial aneurysm growth: a systematic review and meta-analysis. Stroke. 2016;47(4):951\u2013957."},{"issue":"3","key":"b13","series-title":"J Neurosurg","first-page":"843","article-title":"Growth and rupture of unruptured intracranial aneurysms","volume":"131","author":"Juvela S","year":"2018","unstructured":"Juvela S. Growth and rupture of unruptured intracranial aneurysms. J Neurosurg. 2018;131(3):843\u2013851."},{"issue":"8","key":"b14","series-title":"Int J Numer Method Biomed Eng","first-page":"e3844","article-title":"Description of the local hemodynamic environment in intracranial aneurysm wall subdivisions","volume":"40","author":"Karnam Y","year":"2024","unstructured":"Karnam Y, Mut F, Yu AK,  Description of the local hemodynamic environment in intracranial aneurysm wall subdivisions. Int J Numer Method Biomed Eng. 2024;40(8):e3844."},{"issue":"8","key":"b15","series-title":"Int J Numer Method Biomed Eng","first-page":"e3837","article-title":"Distribution of rupture sites and blebs on intracranial aneurysm walls suggests distinct rupture patterns in ACom and MCA aneurysms","volume":"40","author":"Karnam Y","year":"2024","unstructured":"Karnam Y, Mut F, Yu AK,  Distribution of rupture sites and blebs on intracranial aneurysm walls suggests distinct rupture patterns in ACom and MCA aneurysms. Int J Numer Method Biomed Eng. 2024;40(8):e3837."},{"issue":"6","key":"b16","series-title":"Int J Numer Methods Biomed Eng","first-page":"822","article-title":"Computational hemodynamics framework for the analysis of cerebral aneurysms","volume":"27","author":"Mut F","year":"2011","unstructured":"Mut F, L\u00f6hner R, Chien A,  Computational hemodynamics framework for the analysis of cerebral aneurysms. Int J Numer Methods Biomed Eng. 2011;27(6):822\u2013839."},{"issue":"12","key":"b17","series-title":"Ann Biomed Eng","first-page":"3553","article-title":"Regional mapping of flow and wall characteristics of intracranial aneurysms","volume":"44","author":"Cebral JR","year":"2016","unstructured":"Cebral JR, Duan X, Gade PS,  Regional mapping of flow and wall characteristics of intracranial aneurysms. Ann Biomed Eng. 2016;44(12):3553\u20133567."},{"key":"b18","series-title":"J Wind Eng Ind Aerodyn","first-page":"14","article-title":"Recent advances in computational wind engineering and fluid\u2013structure interaction","volume":"144","author":"L\u00f6hner R","year":"2015","unstructured":"L\u00f6hner R, Haug E, Michalski A,  Recent advances in computational wind engineering and fluid\u2013structure interaction. J Wind Eng Ind Aerodyn. 2015;144:14\u201323."},{"issue":"1","key":"b19","series-title":"Int J Numer Methods Biomed Eng","first-page":"73","article-title":"Fast numerical solutions of patient-specific blood flows in 3D arterial systems","volume":"26","author":"Mut F","year":"2010","unstructured":"Mut F, Aubry R, L\u00f6hner R, Cebral JR. Fast numerical solutions of patient-specific blood flows in 3D arterial systems. Int J Numer Methods Biomed Eng. 2010;26(1):73\u201385."},{"issue":"1","key":"b20","series-title":"Physiol Meas","first-page":"015006","article-title":"A data-driven approach for addressing the lack of flow waveform data in studies of cerebral arterial flow in older adults","volume":"39","author":"Durka MJ","year":"2018","unstructured":"Durka MJ, Wong IH, Kallmes DF,  A data-driven approach for addressing the lack of flow waveform data in studies of cerebral arterial flow in older adults. Physiol Meas. 2018;39(1):015006."},{"issue":"4","key":"b21","series-title":"J Neurointerv Surg","first-page":"392","article-title":"Evaluation of predictive models of aneurysm focal growth and bleb development using machine learning techniques","volume":"16","author":"Hadad S","year":"2024","unstructured":"Hadad S, Mut F, Slawski M, Robertson AM, Cebral JR. Evaluation of predictive models of aneurysm focal growth and bleb development using machine learning techniques. J Neurointerv Surg. 2024;16(4):392\u2013397."},{"issue":"11","key":"b22","series-title":"Int J Numer Methods Biomed Eng","first-page":"e3133","article-title":"Combining data from multiple sources to study mechanisms of aneurysm disease: tools and techniques","volume":"34","author":"Cebral JR","year":"2018","unstructured":"Cebral JR, Mut F, Gade P,  Combining data from multiple sources to study mechanisms of aneurysm disease: tools and techniques. Int J Numer Methods Biomed Eng. 2018;34(11):e3133."},{"issue":"11","key":"b23","series-title":"Stroke","first-page":"2997","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 L","year":"2008","unstructured":"Boussel L, Rayz V, McCulloch C,  Aneurysm growth occurs at region of low wall shear stress: patient-specific correlation of hemodynamics and growth in a longitudinal study. Stroke. 2008;39(11):2997\u20133002."},{"issue":"9","key":"b24","series-title":"AJNR Am J Neuroradiol","first-page":"1732","article-title":"Wall shear stress distribution inside growing cerebral aneurysm","volume":"32","author":"Tanoue T","year":"2011","unstructured":"Tanoue T, Tateshima S, Villablanca JP, Vi\u00f1uela F, Tanishita K. Wall shear stress distribution inside growing cerebral aneurysm. AJNR Am J Neuroradiol. 2011;32(9):1732\u20131737."},{"issue":"5","key":"b25","series-title":"World Neurosurg","first-page":"462","article-title":"Hemodynamic analysis of growing intracranial aneurysms arising from a posterior inferior cerebellar artery","volume":"78","author":"Sugiyama S","year":"2012","unstructured":"Sugiyama S, Meng H, Funamoto K,  Hemodynamic analysis of growing intracranial aneurysms arising from a posterior inferior cerebellar artery. World Neurosurg. 2012;78(5):462\u2013468."},{"issue":"1","key":"b26","series-title":"Neurosurg Focus","first-page":"E13","article-title":"Hemodynamic and morphological characteristics of a growing cerebral aneurysm","volume":"47","author":"Dabagh M","year":"2019","unstructured":"Dabagh M, Nair P, Gounley J, Frakes D, Gonzalez LF, Randles A. Hemodynamic and morphological characteristics of a growing cerebral aneurysm. Neurosurg Focus. 2019;47(1):E13."},{"issue":"2","key":"b27","series-title":"Clin Neuroradiol","first-page":"285","article-title":"Hemodynamics of focal versus global growth of small cerebral aneurysms","volume":"29","author":"Machi P","year":"2019","unstructured":"Machi P, Ouared R, Brina O,  Hemodynamics of focal versus global growth of small cerebral aneurysms. Clin Neuroradiol. 2019;29(2):285\u2013293."},{"issue":"7","key":"b28","series-title":"AJNR Am J Neuroradiol","first-page":"1254","article-title":"High WSS or low WSS? Complex interactions of hemodynamics with intracranial aneurysm initiation, growth, and rupture: toward a unifying hypothesis","volume":"35","author":"Meng H","year":"2014","unstructured":"Meng H, Tutino VM, Xiang J, Siddiqui A. High WSS or low WSS? Complex interactions of hemodynamics with intracranial aneurysm initiation, growth, and rupture: toward a unifying hypothesis. AJNR Am J Neuroradiol. 2014;35(7):1254\u20131262."},{"issue":"4","key":"b1","series-title":"AJNR Am J Neuroradiol","first-page":"615","article-title":"Risk factors for growth of intracranial aneurysms: a systematic review and meta-analysis","volume":"37","author":"Brinjikji W","year":"2016","unstructured":"Brinjikji W, Zhu YQ, Lanzino G,  Risk factors for growth of intracranial aneurysms: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2016;37(4):615\u2013620."},{"issue":"1","key":"b2","series-title":"Radiology","first-page":"258","article-title":"Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors","volume":"269","author":"Villablanca JP","year":"2013","unstructured":"Villablanca JP, Duckwiler GR, Jahan R,  Natural history of asymptomatic unruptured cerebral aneurysms evaluated at CT angiography: growth and rupture incidence and correlation with epidemiologic risk factors. Radiology. 2013;269(1):258\u2013265."},{"key":"b3","series-title":"World Neurosurg","first-page":"e425","article-title":"PHASES and ELAPSS scores are associated with aneurysm growth: a study of 431 unruptured intracranial aneurysms","volume":"114","author":"Brinjikji W","year":"2018","unstructured":"Brinjikji W, Pereira VM, Khumtong R,  PHASES and ELAPSS scores are associated with aneurysm growth: a study of 431 unruptured intracranial aneurysms. World Neurosurg. 2018;114:e425\u2013e432."},{"issue":"4","key":"b4","series-title":"J Neurointerv Surg","first-page":"407","article-title":"Hemodynamics in growing and stable cerebral aneurysms","volume":"8","author":"Sforza DM","year":"2016","unstructured":"Sforza DM, Kono K, Tateshima S, Vi\u00f1uela F, Putman C, Cebral JR. Hemodynamics in growing and stable cerebral aneurysms. J Neurointerv Surg. 2016;8(4):407\u2013412."},{"issue":"4","key":"b5","series-title":"Brain Sci","first-page":"520","article-title":"Morphological and hemodynamic changes during cerebral aneurysm growth","volume":"11","author":"Nordahl ER","year":"2021","unstructured":"Nordahl ER, Uthamaraj S, Dennis KD,  Morphological and hemodynamic changes during cerebral aneurysm growth. Brain Sci. 2021;11(4):520."},{"issue":"12","key":"b6","series-title":"AJNR Am J Neuroradiol","first-page":"2102","article-title":"Comparing morphology and hemodynamics of stable-versus-growing and grown intracranial aneurysms","volume":"40","author":"Leemans EL","year":"2019","unstructured":"Leemans EL, Cornelissen BMW, Slump CH, Majoie CBLM, Cebral JR, Marquering HA. Comparing morphology and hemodynamics of stable-versus-growing and grown intracranial aneurysms. AJNR Am J Neuroradiol. 2019;40(12):2102\u20132110."},{"issue":"6","key":"b7","series-title":"Stroke","first-page":"1924","article-title":"Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation","volume":"38","author":"Meng H","year":"2007","unstructured":"Meng H, Wang Z, Hoi Y,  Complex hemodynamics at the apex of an arterial bifurcation induces vascular remodeling resembling cerebral aneurysm initiation. Stroke. 2007;38(6):1924\u20131931."},{"issue":"21","key":"b8","series-title":"JAMA","first-page":"2035","article-title":"Hemodynamic shear stress and its role in atherosclerosis","volume":"282","author":"Malek AM","year":"1999","unstructured":"Malek AM, Alper SL, Izumo S. Hemodynamic shear stress and its role in atherosclerosis. JAMA. 1999;282(21):2035\u20132042."},{"issue":"11","key":"b9","series-title":"Stroke","first-page":"2500","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 M","year":"2004","unstructured":"Shojima M, Oshima M, Takagi K,  Magnitude and role of wall shear stress on cerebral aneurysm: computational fluid dynamic study of 20 middle cerebral artery aneurysms. Stroke. 2004;35(11):2500\u20132505."},{"issue":"21","key":"b10","series-title":"Comput Struc","first-page":"1326","article-title":"Blood flow dynamics and arterial wall interaction in a saccular aneurysm model of the basilar artery","volume":"84","author":"Valencia A","year":"2006","unstructured":"Valencia A, Solis F. Blood flow dynamics and arterial wall interaction in a saccular aneurysm model of the basilar artery. Comput Struc. 2006;84(21):1326\u20131337."},{"issue":"8","key":"b11","series-title":"Stroke","first-page":"1774","article-title":"Characterization of critical hemodynamics contributing to aneurysmal remodeling at the basilar terminus in a rabbit model","volume":"41","author":"Metaxa E","year":"2010","unstructured":"Metaxa E, Tremmel M, Natarajan SK,  Characterization of critical hemodynamics contributing to aneurysmal remodeling at the basilar terminus in a rabbit model. Stroke. 2010;41(8):1774\u20131782."},{"issue":"4","key":"b12","series-title":"Stroke","first-page":"951","article-title":"Patient- and aneurysm-specific risk factors for intracranial aneurysm growth: a systematic review and meta-analysis","volume":"47","author":"Backes D","year":"2016","unstructured":"Backes D, Rinkel GJE, Laban KG, Algra A, Vergouwen MDI. Patient- and aneurysm-specific risk factors for intracranial aneurysm growth: a systematic review and meta-analysis. Stroke. 2016;47(4):951\u2013957."},{"issue":"3","key":"b13","series-title":"J Neurosurg","first-page":"843","article-title":"Growth and rupture of unruptured intracranial aneurysms","volume":"131","author":"Juvela S","year":"2018","unstructured":"Juvela S. Growth and rupture of unruptured intracranial aneurysms. J Neurosurg. 2018;131(3):843\u2013851."},{"issue":"8","key":"b14","series-title":"Int J Numer Method Biomed Eng","first-page":"e3844","article-title":"Description of the local hemodynamic environment in intracranial aneurysm wall subdivisions","volume":"40","author":"Karnam Y","year":"2024","unstructured":"Karnam Y, Mut F, Yu AK,  Description of the local hemodynamic environment in intracranial aneurysm wall subdivisions. Int J Numer Method Biomed Eng. 2024;40(8):e3844."},{"issue":"8","key":"b15","series-title":"Int J Numer Method Biomed Eng","first-page":"e3837","article-title":"Distribution of rupture sites and blebs on intracranial aneurysm walls suggests distinct rupture patterns in ACom and MCA aneurysms","volume":"40","author":"Karnam Y","year":"2024","unstructured":"Karnam Y, Mut F, Yu AK,  Distribution of rupture sites and blebs on intracranial aneurysm walls suggests distinct rupture patterns in ACom and MCA aneurysms. Int J Numer Method Biomed Eng. 2024;40(8):e3837."},{"issue":"6","key":"b16","series-title":"Int J Numer Methods Biomed Eng","first-page":"822","article-title":"Computational hemodynamics framework for the analysis of cerebral aneurysms","volume":"27","author":"Mut F","year":"2011","unstructured":"Mut F, L\u00f6hner R, Chien A,  Computational hemodynamics framework for the analysis of cerebral aneurysms. Int J Numer Methods Biomed Eng. 2011;27(6):822\u2013839."},{"issue":"12","key":"b17","series-title":"Ann Biomed Eng","first-page":"3553","article-title":"Regional mapping of flow and wall characteristics of intracranial aneurysms","volume":"44","author":"Cebral JR","year":"2016","unstructured":"Cebral JR, Duan X, Gade PS,  Regional mapping of flow and wall characteristics of intracranial aneurysms. Ann Biomed Eng. 2016;44(12):3553\u20133567."},{"key":"b18","series-title":"J Wind Eng Ind Aerodyn","first-page":"14","article-title":"Recent advances in computational wind engineering and fluid\u2013structure interaction","volume":"144","author":"L\u00f6hner R","year":"2015","unstructured":"L\u00f6hner R, Haug E, Michalski A,  Recent advances in computational wind engineering and fluid\u2013structure interaction. J Wind Eng Ind Aerodyn. 2015;144:14\u201323."},{"issue":"1","key":"b19","series-title":"Int J Numer Methods Biomed Eng","first-page":"73","article-title":"Fast numerical solutions of patient-specific blood flows in 3D arterial systems","volume":"26","author":"Mut F","year":"2010","unstructured":"Mut F, Aubry R, L\u00f6hner R, Cebral JR. Fast numerical solutions of patient-specific blood flows in 3D arterial systems. Int J Numer Methods Biomed Eng. 2010;26(1):73\u201385."},{"issue":"1","key":"b20","series-title":"Physiol Meas","first-page":"015006","article-title":"A data-driven approach for addressing the lack of flow waveform data in studies of cerebral arterial flow in older adults","volume":"39","author":"Durka MJ","year":"2018","unstructured":"Durka MJ, Wong IH, Kallmes DF,  A data-driven approach for addressing the lack of flow waveform data in studies of cerebral arterial flow in older adults. Physiol Meas. 2018;39(1):015006."},{"issue":"4","key":"b21","series-title":"J Neurointerv Surg","first-page":"392","article-title":"Evaluation of predictive models of aneurysm focal growth and bleb development using machine learning techniques","volume":"16","author":"Hadad S","year":"2024","unstructured":"Hadad S, Mut F, Slawski M, Robertson AM, Cebral JR. Evaluation of predictive models of aneurysm focal growth and bleb development using machine learning techniques. J Neurointerv Surg. 2024;16(4):392\u2013397."},{"issue":"11","key":"b22","series-title":"Int J Numer Methods Biomed Eng","first-page":"e3133","article-title":"Combining data from multiple sources to study mechanisms of aneurysm disease: tools and techniques","volume":"34","author":"Cebral JR","year":"2018","unstructured":"Cebral JR, Mut F, Gade P,  Combining data from multiple sources to study mechanisms of aneurysm disease: tools and techniques. Int J Numer Methods Biomed Eng. 2018;34(11):e3133."},{"issue":"11","key":"b23","series-title":"Stroke","first-page":"2997","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 L","year":"2008","unstructured":"Boussel L, Rayz V, McCulloch C,  Aneurysm growth occurs at region of low wall shear stress: patient-specific correlation of hemodynamics and growth in a longitudinal study. Stroke. 2008;39(11):2997\u20133002."},{"issue":"9","key":"b24","series-title":"AJNR Am J Neuroradiol","first-page":"1732","article-title":"Wall shear stress distribution inside growing cerebral aneurysm","volume":"32","author":"Tanoue T","year":"2011","unstructured":"Tanoue T, Tateshima S, Villablanca JP, Vi\u00f1uela F, Tanishita K. Wall shear stress distribution inside growing cerebral aneurysm. 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