Subarachnoid hemorrhage results from a ruptured intracranial aneurysm. The PhD thesis of Torbjørn Øgard Skodvin can make it easier to identify patients that need brain surgery.
MAIN RESULTS:
- Postrupture morphology could be inaccurate to evaluate the rupture risk of intact intracranial aneurysms.
- Hemodynamics at the time of diagnosis could be early predictors of rupture.
- The prerupture morphology of an aneurysm could be of value when assessing rupture risk.
THESIS DEFENCE:
Thesis: Predicting rupture of intracranial aneurysms: morphological and hemodynamic parameters
Candidate: Torbjørn Øgard Skodvin
Time: April 27, 2018 at 12:15
Place: UiT The Arctic University of Norway: MH-building, Auditorium 7
Link to university website (in Norwegian)
SUMMARY:
(1) Using postrupture morphology to predict rupture risk of an intracranial aneurysm is inaccurate because of morphological changes at the time of rupture. By comparing pre- and postrupture angiograms from 29 patients, Skodvin and colleagues found that almost all one-dimensional parameter medians were significantly larger after rupture. They conclude that aneurysm morphology changes both as a result of time and the rupture per se.
(2) The hemodynamic parameter called low shear area was significantly higher in patients who later experienced a rupture, compared to patients with stable intact aneurysms. Several other hemodynamic parameters also showed a tendency to be associated with later rupture. Thus, hemodynamics at the time of diagnosis could be early predictors of rupture.
In this study, 12 intracranial aneurysms that later ruptured were matched with 24 control aneurysms that remained unruptured during approximately five years follow-up. Hemodynamic parameters were obtained from computational simulations.
(3) A straighter inflow angle may predispose an aneurysm to changes that increase the risk of rupture, but this was the only morphological parameter that was associated with later rupture. The researchers analyzed angiograms from 12 cases and 24 controls, and conclude that traditional parameters of aneurysm morphology may be of limited value in predicting rupture of an intracranial aneurysm.
REFERENCES:
(1) Skodvin, T. Ø., Johnsen, L. H., Gjertsen, Ø., Isaksen, J. G., & Sorteberg, A. (2017). Cerebral aneurysm morphology before and after rupture: nationwide case series of 29 aneurysms. Stroke, 48(4), 880-886.
(2) Skodvin, T. Ø., Evju, Ø., Helland, C. A., & Isaksen, J. G. (2017). Rupture prediction of intracranial aneurysms: a nationwide matched case-control study of hemodynamics at the time of diagnosis. Journal of neurosurgery, 1-7.
(2) Skodvin, T. Ø., Evju, Ø., Sorteberg, A., & Isaksen, J. G. (2018). Prerupture Intracranial Aneurysm Morphology in Predicting Risk of Rupture: A Matched Case-Control Study. Neurosurgery.
