Factors of cerebral aneurysm rupture: literature review

Aneurysms are pathological dilatations of blood vessels lumens. Rupture of aneurysm leads to subarachnoid hemorrhage and, as a consequence, to hemorrhagic stroke. Mortality reaches 45%, and half of the survivors experiences serious neurological problems. Diagnosis of cerebral aneurysms is difficult due to the fact that they, as a rule, do not have typical symptoms. Nevertheless, diagnostics using computer or magnetic resonance tomography makes it possible to detect aneurysms and determine their morphology quite accurately. Today, the problem of identifying and determining the characteristics of aneurysms is quite acute, since preventive surgical treatment entails serious postoperative complications, and untimely treatment leads to their rupture and, as a consequence, to a stroke. The development of methods and criteria for assessing risk of aneurysm rupture is an urgent scientific problem. It is necessary to understand whether an aneurysm is prone to rupture in order to form a treatment tactics. The authors, first of all, investigate absolute sizes, as well as relative geometric characteristics. These data can be obtained by performing diagnostic procedures using computer and magnetic resonance imaging. Separately, it is necessary to note mechanical factors, which are identified on the basis of full-scale and numerical experiments. In this work, an overview of modern studies devoted to the identification and validation of the applicability of predictors and factors of rupture of intracranial aneurysms is reviewed. Numerical values of factors are given, and the question of the possibility of their application in diagnosis and preoperative planning of treatment is raised.