On the origin of

cerebral
aneurysms
a scientific model
Haim Ezer, MD
48, Y/O W F
 Study questions
• What is the pathogenesis of cerebral aneurysms
• Why are they distributed in an anatomical
fashion?
• Why does one individual develop an aneurysm,
and another does not?
• Could we screen for cerebral aneurysm
• Why does a certain individual develop an
aneurysm, in a certain location and not in
another?
The “kink” point
 Methods
High curvature

But on aneurysms:

Low curvature
The JIZ – Jet Impact Zone
 Methods
3. Centerline extraction 4. Curvature calculation High curvature

Low curvature
 Study conclusions:

• 1. Cerebral arterial 3D curvature is kept

below a threshold of 0.7mm-1
• 2. The parent artery to an aneurysm, is at least
2mm in diameter.
• 3. Aneurysms develop only in the jet impact
zone.
 Answered questions
• Why do certain individuals develop aneurysms
and others don’t.
• Why do they develop them in certain locations
• A screening tool possible
• High correlation to circle of Willis 3D
geometry
Transcranial Doppler (TCD)
TCD

MRA reconstruction
 Unanswered questions
• Why do certain individuals have theses sharp
bends and others don’t. (diff equations)
• Does beta blockers prevent aneurysm
formation
• Could TCD give a better resolution image