title: Hemodynamic and morphological characteristics of unruptured posterior communicating artery aneurysms with oculomotor nerve palsy.
abstract: OBJECT Unruptured posterior communicating artery (PCoA) aneurysms with oculomotor nerve palsy (ONP) have a very high risk of rupture. This study investigated the hemodynamic and morphological characteristics of intracranial aneurysms with high rupture risk by analyzing PCoA aneurysms with ONP. METHODS Fourteen unruptured PCoA aneurysms with ONP, 33 ruptured PCoA aneurysms, and 21 asymptomatic unruptured PCoA aneurysms were included in this study. The clinical, morphological, and hemodynamic characteristics were compared among the different groups. RESULTS The clinical characteristics did not differ among the 3 groups (p > 0.05), whereas the morphological and hemodynamic analyses showed that size, aspect ratio, size ratio, undulation index, nonsphericity index, ellipticity index, normalized wall shear stress (WSS), and percentage of low WSS area differed significantly (p < 0.05) among the 3 groups. Furthermore, multiple comparisons revealed that these parameters differed significantly between the ONP group and the asymptomatic unruptured group and between the ruptured group and the asymptomatic unruptured group, except for size, which differed significantly only between the ONP group and the asymptomatic unruptured group (p = 0.0005). No morphological or hemodynamic parameters differed between the ONP group and the ruptured group. CONCLUSIONS Unruptured PCoA aneurysms with ONP demonstrated a distinctive morphological-hemodynamic pattern that was significantly different compared with asymptomatic unruptured PCoA aneurysms and was similar to ruptured PCoA aneurysms. The larger size, more irregular shape, and lower WSS might be related to the high rupture risk of PCoA aneurysms.
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China; and.
authors.forename: Nan
authors.initials: N
authors.lastname: Lv
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China; and.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yu
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China; and.
authors.forename: Jinyu
authors.initials: J
authors.lastname: Xu
authors.affiliation: Cerebrovascular Center, Department of Neurosurgery, Houston Methodist, Houston, Texas.
authors.forename: Christof
authors.initials: C
authors.lastname: Karmonik
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China; and.
authors.forename: Jianmin
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China; and.
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006439:Hemodynamics; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000150:complications; D012189:Retrospective Studies
keywords: AR = aspect ratio; CFD = computational fluid dynamics; EI = ellipticity index; IA = intracranial aneurysm; LSA = low WSS area; NSI = nonsphericity index; ONP = oculomotor nerve palsy; OSI = oscillatory shear index; PCoA = posterior communicating artery; RA = rotational angiography; SR = size ratio; UI = undulation index; WSS = wall shear stress; computational fluid dynamics; hemodynamics; intracranial aneurysm; morphology; rupture; vascular disorders