الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Intracranial saccular aneurysms are acquired vascular abnormalities that cause outpouching of the arterial wall. They are often located at the bifurcation of the arteries in the anterior circulation of the Circle of Willis. There has been increased detection of unruptured intracranial aneurysms in clinical practice due to the frequent use of CT and MRI.
Intracranial aneurysms occur in 1-2% of the population and account for about 80–85% of non-traumatic subarachnoid hemorrhage.
Cerebral aneurysms have been classified based on a number of features, including etiology (congenital, acquired, dissecting, infectious, tumorous), size (tiny, small, large, giant), shape (fusiform, saccular), or association with a specific intracranial branch vessel, Or based on flow dynamics of the blood.
Several factors have been found to be associated with an increased risk of rupture: these include both anatomical features (i.e. aneurysm size, specific location, presence of a sac bleb), and demographic characteristics and medical conditions (female sex, age over 60, hypertension, and smoking).
The development, progression, and rupture of cerebral aneurysms are complex multifactorial processes that are still not well understood. It is generally accepted that hemodynamics plays a fundamental role in these processes. However, there is still no consensus about which hemodynamic variables are implicated in these mechanisms. Because hemodynamics strongly depends on the vascular geometry, better understanding the interaction between hemodynamic loading and mechano-biological wall responses that govern the natural history of cerebral aneurysms requires investigations of the in vivo aneurysmal hemodynamics environment.
Image-based computational flow dynamics CFD is capable of realistically representing this hemodynamics environment, and therefore it can be used to relate hemodynamic characteristics and aneurysm initiation, growth and rupture. Thus, patient-specific CFD constitutes a promising approach for studying these complex mechanisms and can potentially be used to assess rupture risk, and therefore has a great potential for clinical use in the diagnosis and treatment of this disease.
The aim of the present work is to study the different pattern of computational flow dynamics of ruptured bilobed cerebral aneurysm
In this study ten patients with ruptured bilobed cerebral aneurysm presenting to Alexandria university hospitals were included
Exclusion criteria:
1. Patients with traumatic intracerebral haemorhage.
2. Patients with giant aneurysms.
3. Patients with dural arterio-venous fistula.
4. Patients with arterio-venous malforamation (AVM).
5. Patients on oral or injectable anticoagulation.
All the patients were subjected to the following:
Complete history taking including: age, sex, age of hemorrhage, previous medical and surgical history, family history of cerebral aneurysm.
Complete neurological examination.
Routine laboratory investigations including.
Complete blood picture (CBC).
Blood Urea Nitrogen (BUN), creatinine level.
Liver enzymes.
Fasting blood glucose.
Brain imaging.
(CT brain).
CT angiography
Digital subtraction angiography (DSA).
The medical image used in the workshop was obtained using rotational acquisition in a Siemens Healthcare Artis Zee ceiling producing 100 images in 6 seconds, with 5 ms exposure per image. Voxel size in the reconstructed 3D images was 234 microns with reconstruction matrix.