Cerebral Aneurysm Size and Distal Intracranial Hemodynamics: An Assessment of Flow and Pulsatility Index Using Quantitative Magnetic Resonance Angiography

Hussein, Ahmed E.; Brunozzi, Denise; Ismail, Rahim; Charbel, Fady T.; Alaraj, Ali

doi:10.1093/neuros/nyx441

Cited by 17 publications

(23 citation statements)

References 11 publications

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“…In addition, a study in the literature reported that the relationship between cerebral aneurysm size and risk of rupture was well documented but the effect of aneurysms on distal intracranial hemodynamics was not known [11]. The aneurysm P a g e / S a y f a 52 cases (unruptured and unilateral) included in our study were similar to this study in the literature.…”

Section: Discussionsupporting

confidence: 76%

Tek taraflı intrakranial anevrizmalı hastalarda servikal kan akış hızı değerleri: Ön sonuçlar

Tekin

Pehlivan

Kitiş

2019

Archives of Clinical and Experimental Medicine

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Brain aneurysm is a balloon shaped dilatation of brain vessels as a result of attenuation of the vessel walls. The aim of this study was to evaluate the relationship between blood flow velocities in the right and left arterial vessels in an unruptured aneurysm and healthy group, and to investigate whether this analysis can help early diagnosis of aneurysm. Methods: Four aneurysm patients (four female, mean age 57.25 ± 0.75 years) and four healthy subjects (two female, 2 male male, mean age 36.35 ± 6.19 years) were included in the study. Blood flow velocity values of right and left internal carotid arteries, vertebral artery and right and left internal jugular veins were obtained during a cardiac cycle with phase contrast technique. Spearman's correlation analysis was applied to flow velocity values. Statistically significant blood flow similarities between right and left brain were investigated. Results: In the aneurysm group, there was a significant difference between right and left cervical arterial blood flow velocity values (p=0.001). Spearman correlation coefficient values between right and left arterial blood flow velocity values and right and left side arteriovenous blood flow velocity values were lower in the aneurysm group compared to the control group however, there was no statistical significance (p≥0.05 for all). Conclusion: The difference between the right and left arterial blood flow velocities obtained in the aneurysm group and the low correlation values may be useful in early diagnosis of aneurysm.

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Section: Discussionsupporting

confidence: 76%

Tek taraflı intrakranial anevrizmalı hastalarda servikal kan akış hızı değerleri: Ön sonuçlar

Tekin

Pehlivan

Kitiş

2019

Archives of Clinical and Experimental Medicine

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“…It has been described that in arterial aneurysms, a Windkessel effect takes place, where the aneurysm acts as a reservoir for blood during systole and releases it during diastole. This results in lower pulse pressure, because of increased vascular resistance distally [9,10]. This was supported by a study by Hussein et al [9], where the authors demonstrated the relationship between the size of internal carotid artery aneurysms and distal intracranial hemodynamics.…”

Section: Macrocirculation and Pulsatilitymentioning

confidence: 69%

“…This results in lower pulse pressure, because of increased vascular resistance distally [9,10]. This was supported by a study by Hussein et al [9], where the authors demonstrated the relationship between the size of internal carotid artery aneurysms and distal intracranial hemodynamics. They have measured flow and pulsatility index within bilateral middle cerebral arteries and internal carotid arteries prior to initiating any treatment.…”

Section: Macrocirculation and Pulsatilitymentioning

confidence: 69%

“…Loss of this elastic reservoir has several negative effects on the cardiovascular system and has the potential to damage end-organ circulation. With the loss of elasticity, there is an increase in pulsatile load of the heart, which has detrimental effects on the left ventricle through increasing its mass and thus the myocardial oxygen demand [9]. Additionally, the increased pulsations resulting from the stiffness of large vessels are believed to affect the capillary networks, resulting in microvascular complications, as they allow the harmful pulsations to be conducted into end-organ microcirculation [10].…”

Section: Macrocirculation and Pulsatilitymentioning

confidence: 99%

“…The complex elastic fiber mesh in large blood vessels begins its synthesis development in early embryogenesis, a process which continues up until early childhood. As a result, adults have a relatively fixed amount of elastic fibers in their aorta, which slowly stretch out, degenerate and become replaced by much less compliant collagen fibers [9]. As shown by Eberth et al increasing pulsatile pressure and continuous flow injury on the vascular wall result in a significant increase in the number of cells and an increased collagen-to-elastin ratio with further aortic wall thickening and luminal narrowing [11].…”

Section: Macrocirculation and Pulsatilitymentioning

confidence: 99%

See 2 more Smart Citations

Clinical application of pulsatility index

Wielicka

Neubauer-Geryk

Kozera

et al. 2020

Medical Research Journal

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Pulsatility index (PI) is defined as the difference between the peak systolic flow and minimum diastolic flow velocity, divided by the mean velocity recorded throughout the cardiac cycle. It is a non-invasive method of assessing vascular resistance with the use of Doppler ultrasonography. It was first introduced in 1974 by Gosling and King and is also known as the Gosling Index. PI as a method of examining macrocirculation has a variety of clinical applications. For instance, in diabetic patients, it has been measured on the common carotid, middle cerebral or renal arteries to help predict complications such as cerebrovascular disease or nephropathy. In hypertensive patients, it has been used to assess complications and assess the chronicity of the disease. To our knowledge, despite the diverse use of this ultrasonographic parameter, there is a deficiency in reports that would comprehensively summarize its clinical applications. Based on our extensive review of the literature and the gathered information, we conclude that pulsatility index (PI) is an easy to obtain parameter with a broad range of both, research and clinical applications. It has been widely used in the assessment of macrocirculation in highly prevalent chronic medical conditions, such as hypertension, both type 1 and type 2 diabetes and thyroid disorders.

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Diagnostic reliability of the Berlin classification for complex MCA aneurysms—usability in a series of only giant aneurysms

et al. 2020

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Background and objective The main challenge of bypass surgery of complex MCA aneurysms is not the selection of the bypass type but the initial decision-making of how to exclude the affected vessel segment from circulation. To this end, we have previously proposed a classification for complex MCA aneurysms based on the preoperative angiography. The current study aimed to validate this new classification and assess its diagnostic reliability using the giant aneurysm registry as an independent data set. Methods We reviewed the pretreatment neuroimaging of 51 patients with giant (> 2.5 cm) MCA aneurysms from 18 centers, prospectively entered into the international giant aneurysm registry. We classified the aneurysms according to our previously proposed Berlin classification for complex MCA aneurysms. To test for interrater diagnostic reliability, the data set was reviewed by four independent observers. Results We were able to classify all 51 aneurysms according to the Berlin classification for complex MCA aneurysms. Eight percent of the aneurysm were classified as type 1a, 14% as type 1b, 14% as type 2a, 24% as type 2b, 33% as type 2c, and 8% as type 3. The interrater reliability was moderate with Fleiss’s Kappa of 0.419. Conclusion The recently published Berlin classification for complex MCA aneurysms showed diagnostic reliability, independent of the observer when applied to the MCA aneurysms of the international giant aneurysm registry.

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Cerebral Aneurysm Size and Distal Intracranial Hemodynamics: An Assessment of Flow and Pulsatility Index Using Quantitative Magnetic Resonance Angiography

Abstract: Larger aneurysm size correlates with higher ipsilateral MCA PI, demonstrating that aneurysms affect distal intracranial hemodynamics.

Cited by 17 publications

References 11 publications

Tek taraflı intrakranial anevrizmalı hastalarda servikal kan akış hızı değerleri: Ön sonuçlar

Tek taraflı intrakranial anevrizmalı hastalarda servikal kan akış hızı değerleri: Ön sonuçlar

Clinical application of pulsatility index

Diagnostic reliability of the Berlin classification for complex MCA aneurysms—usability in a series of only giant aneurysms

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