Brain Hemorrhages最新文献

{"title":"Step-down infusion of barbiturate improves neurofunction in a new rat model of rebleeding subarachnoid hemorrhage","authors":"Sosho Kajiwara ,&nbsp;Yu Hasegawa ,&nbsp;Kana Fujimori ,&nbsp;Motohiro Morioka","doi":"10.1016/j.hest.2024.07.001","DOIUrl":"10.1016/j.hest.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>Rebleeding from a ruptured aneurysm is a risk factor for fatal prognosis in subarachnoid hemorrhage (SAH). A novel barbiturate treatment, step-down infusion of barbiturate (sd-B), was previously developed; it showed beneficial effects on patients with severe traumatic brain injuries. The present study established a rebleeding SAH model in rats and evaluated the effect of sd-B.</div></div><div><h3>Methods</h3><div>Fifty male Sprague-Dawley rats were divided into sham-operation with distilled water, sham-operation with barbiturate, SAH-rebleeding with distilled water, and SAH-rebleeding with barbiturate groups. For posttreatment with sd-B, thiamylal was intraperitoneally administered at 3 mg/kg/h on days 0–1, 2 mg/kg/h on days 1–2, and 1 mg/kg/h on days 2–3 after SAH using osmotic minipumps. We monitored neurofunction and case fatality as the primary endpoints and evaluated brain injuries, including brain edema and cortical neuronal cell death, as the secondary endpoints</div></div><div><h3>Results</h3><div>Posttreatment with sd-B improved the modified Garcia test, reduced the brain water content, and inhibited the loss of neuronal cells and microglial expressions in the rat model.</div></div><div><h3>Conclusions</h3><div>Our results revealed that sd-B ameliorated neurofunction and brain injuries on the rebleeding SAH model, suggesting that the novel treatment is a good candidate drug for patients with SAH with rebleeding.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 2","pages":"Pages 64-68"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune cells in intracerebral hemorrhage","authors":"Irem Culha Taskin,&nbsp;Yao Yao","doi":"10.1016/j.hest.2025.02.001","DOIUrl":"10.1016/j.hest.2025.02.001","url":null,"abstract":"<div><div>Intracerebral hemorrhage (ICH), the deadliest form of stroke, is characterized by bleeding into brain parenchyma and formation of hematoma. Currently, there is no treatment available for ICH. Inflammatory response is a key pathology of ICH and plays a dual role in ICH---contributing to both secondary brain injury and recovery processes. This review discusses different types (both brain-resident and infiltrated) of immune cells and their functions during inflammation processes following ICH. Specifically, the temporal dynamics, polarization, and function of microglia/macrophages, neutrophils, lymphocytes, and astrocytes in ICH are summarized in a cell-specific manner. In addition, we also discuss key challenges and unanswered questions that need to be addressed in the future. A thorough understanding of the functions of different immune cells in ICH will provide a strong foundation for future studies and lead to the identification of novel cellular/molecular targets for therapeutic development.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 2","pages":"Pages 86-94"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No association of brain CT blend sign with functional outcomes in patients with spontaneous supratentorial intracerebral hemorrhage after craniotomy","authors":"Li Luo ,&nbsp;Jinhua Yang ,&nbsp;Lian He ,&nbsp;Shiqi Lin ,&nbsp;Desislava Doycheva ,&nbsp;Siying Ren ,&nbsp;Likun Wang","doi":"10.1016/j.hest.2024.08.001","DOIUrl":"10.1016/j.hest.2024.08.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study retrospectively analyzed the association of blend sign with long-term outcomes in patients who underwent craniotomy following spontaneous supratentorial intracerebral hemorrhage.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on a cohort comprising 259 patients. Initially, patients were stratified into two groups: the blend sign group and the non-blend sign group. Subsequently, the neurological status of these patients was assessed using the NIHSS, GCS, and mRS following craniotomy. Furthermore, at six months post-craniotomy, patients were categorized into either the “good outcome group” or the “poor outcome group”. A multivariate regression analysis was applied to ascertain the independent correlation between the CT blend sign and prognosis.</div></div><div><h3>Results</h3><div>No statistically significant disparities were observed in the proportion of patients experiencing favorable outcomes during the follow-up period between the two groups. Nevertheless, it is noteworthy that the incidence of the blend sign was higher among patients in the good outcome group compared to those in the poor outcome group. Multivariate regression analysis disclosed that poor outcomes following craniotomy was not associated with the blend sign.</div></div><div><h3>Conclusions</h3><div>The presence of the blend sign may not serve as a reliable predictor of functional outcomes in patients undergoing craniotomy for spontaneous supratentorial ICH.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 2","pages":"Pages 69-75"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilizing neuroimaging visualization technology to enhance standardized neurosurgical training for Traditional Chinese Medicine residents: A neuroanatomical education study","authors":"Rongjun Zhang ,&nbsp;Zhigang Gong ,&nbsp;Wenbing Jiang ,&nbsp;Zhaofeng Su","doi":"10.1016/j.hest.2024.07.005","DOIUrl":"10.1016/j.hest.2024.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to address the difficulties encountered by Traditional Chinese Medicine (TCM) students in learning neuroanatomy during clinical training by utilizing neuroimaging visualization technology.</div></div><div><h3>Methods</h3><div>81 students were divided into a control group (40 students) and an observation group (41 students). The control group followed traditional teaching methods as prescribed by the curriculum, while the observation group received additional training with the neuroimaging visualization software DSI Studio. This included whole-brain neural fiber reconstruction and cortical spinal tract evaluation in the context of stroke. Upon completion of the training, both groups were assessed on neuroanatomical theory, case analysis, neurological examination, and clinical skills. The teaching effectiveness was compared based on assessment results and feedback from questionnaires administered to the observation group.</div></div><div><h3>Results</h3><div>The observation group significantly outperformed the control group in theoretical knowledge, case analysis, and physical examination (P &lt; 0.05). Over 90 % of students in the observation group reported via questionnaire that the integration of neuroimaging visualization technology significantly enhanced their understanding of neuroanatomy and clinical reasoning skills.</div></div><div><h3>Conclusion</h3><div>The clinical teaching approach augmented with neuroimaging visualization technology significantly improves the standardized training outcomes for TCM neurosurgical residents.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 2","pages":"Pages 81-85"},"PeriodicalIF":1.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune System Perspective in Intracerebral Hemorrhage Research: A Focus on Monocytes and Macrophages","authors":"Hang Hang ,&nbsp;Lei Huang ,&nbsp;Yuanhong Mao ,&nbsp;Guofeng Wu","doi":"10.1016/j.hest.2024.07.004","DOIUrl":"10.1016/j.hest.2024.07.004","url":null,"abstract":"<div><div>Monocytes and macrophages are crucial elements of the immune system, having various roles in tissue balance, inflammation, and conditions like stroke. They exhibit significant functional diversity, particularly evident in the M1 and M2 phenotypes and their marker characteristics. The functions of monocytes and macrophages are crucial in stroke studies, notably those related to intracerebral hemorrhage (ICH). ICH is the most severe type of stroke, characterized by inflammation, oxidative stress, and neuronal death, significantly increasing patient mortality and morbidity. Monocytes and macrophages play key roles in the inflammatory processes following ICH, participating in hematoma clearance and tissue repair. Despite their potential dual roles in the pathophysiology of ICH, involving both harmful and protective effects, the specific mechanisms remain to be further elucidated. This review summarizes the latest research progress on monocyte and macrophage subsets, with a particular focus on their contributions to ICH. It covers the relationships and differences between monocytes and macrophages, the functional diversity of macrophages, cell phenotypes and functions, regulatory mediators, gene expression and transcriptome analysis, and the clinical prognosis associated with blood monocyte counts. These research advancements aim to provide new insights for improving the diagnosis and treatment strategies for ICH.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 30-37"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leakage sign based on contrast-enhanced CT is a predictive marker for hematoma expansion and poor prognosis in primary brainstem hemorrhage","authors":"Motohisa Koga,&nbsp;Yu Hasegawa,&nbsp;Jin Kikuchi,&nbsp;Aya Hashimoto,&nbsp;Keiichiro Furuta,&nbsp;Takehiro Makizono,&nbsp;Hidenobu Yoshitake,&nbsp;Kimihiko Orito,&nbsp;Motohiro Morioka","doi":"10.1016/j.hest.2024.10.003","DOIUrl":"10.1016/j.hest.2024.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>Although hematoma expansion is a poor prognostic factor in patients with intracerebral hemorrhage (ICH), its effect on primary brainstem hemorrhage (PBSH) remains unclear. Since we previously observed the “leakage sign” (LS) on computed tomography (CT) to be a significant predictor for hematoma expansion, we herein investigated the effect of LS in PBSH.</div></div><div><h3>Methods</h3><div>Between January 2013 and August 2023, 515 patients with ICH were admitted to our institute. Thirty-six patients with PBSHs met the inclusion criteria, who were then divided into LS-positive (LS+) and LS-negative (LS-) groups based on the presence of LS. We evaluated hematoma expansion and prognosis at discharge.</div></div><div><h3>Results</h3><div>Patients in the LS+ group had larger baseline hematoma volume and lower Glasgow Coma Scale scores on admission and significantly poor prognosis at discharge. Subgroup analysis revealed that LS was frequently observed within 100 min after the onset of symptoms in patients with a hematoma size of &gt;10 mm³ on CT; additionally, patients in the LS+ group more frequently experienced hematoma expansion and had poor prognosis at discharge.</div></div><div><h3>Conclusions</h3><div>LS is a significant predictive marker for disease severity at admission, hematoma expansion, and poor prognosis at discharge.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 19-23"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of brain surgery: Exploring the impact of continuum robotics","authors":"Shreya Shah ,&nbsp;Pearl Sheth ,&nbsp;Rajvi Shah ,&nbsp;Dhyey Shekhaliya ,&nbsp;Manan Shah","doi":"10.1016/j.hest.2024.11.002","DOIUrl":"10.1016/j.hest.2024.11.002","url":null,"abstract":"<div><div>Brain surgery requires at most accuracy and precision, yet current neurosurgical robots are limited in their ability to reach intracranial regions due to their rigid and inflexible nature. However, Continuum robots have great potential and are currently helping to change the face of neurosurgery as we know it. They overcome the challenges of conventional tools by providing much greater flexibility and control, consequently reducing recovery times and improving patient outcomes. Continuum robots are a class of robots characterized by their higher number of degrees of freedom. This flexibility and maneuverability lead to the possibility of minimally invasive procedures which were not possible with conventional methods. This paper profoundly reviews the major research done in the field of continuum robots in neurosurgery and to provide a comparative analysis along with a discussion of the same. The review discusses the state of neurosurgery before continuum robots, the limitations of conventional tools, and why continuum robots are looking so promising for the future of neurosurgery. A detailed comparative analysis of existing research is tabulated to highlight the current challenges and future scope in the development and application of continuum robots in brain surgery.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 38-56"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioinformatics analysis of potential pathogenesis and risk genes of neuroinflammation-promoted brain injury in intracerebral hemorrhage","authors":"Ilgiz Gareev ,&nbsp;Ozal Beylerli ,&nbsp;Elmar Musaev ,&nbsp;Chunlei Wang ,&nbsp;Valentin Pavlov","doi":"10.1016/j.hest.2024.07.007","DOIUrl":"10.1016/j.hest.2024.07.007","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Spontaneous (non-traumatic) intracerebral hemorrhage (ICH) is one of the major causes of global death. The purpose of our bioinformatics analysis was to detect viable pathophysiological targets and small-molecule drug candidates and to identify the precise secondary mechanisms of brain injury in ICH.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The GSE24265 dataset, consisting of data from four perihematomal brain tissues and seven contralateral brain tissues, was downloaded from the Gene Expression Omnibus (GEO) database and screened for differentially expressed genes (DEGs) in ICH. Online analysis tool GEO2R and Drug Susceptibility Assessment Module within the ACBI Bioinformation tool was used for data differential expression analysis. TargetScan, miRDB, and RNA22 were used to investigate the miRNAs regulating the DEGs. The functional annotation of DEGs was performed using Gene Ontology (GO) resources, and the cell signaling pathway analysis of DEGs was performed using the Kyoto Encyclopedia of Genes and Genomes (KEGG). DAVID is used to perform GO function enrichment analysis and KEGG pathway analysis of candidate target genes. Enrichment analysis was performed for delving the molecular mechanism of DEGs, and protein–protein interaction (PPI) networks and microRNA (miRNA)-messenger RNA (mRNA) networks were used to reveal the hub nodes and the related interaction relationships. Hub genes and miRNA-mRNA interaction of PPI network were identified by STRING version 12.0 online software and Cytoscape. Next, the DEGs were analyzed using the L1000CDS2 database to identify small-molecule compounds with potential therapeutic effects.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 325 upregulated genes and 103 downregulated genes associated with ICH were identified. The biological functions of DEGs associated with ICH are mainly involved in the inflammatory response, chemokine activity, and immune response. The KEGG analysis identified several pathways significantly associated with ICH, including but not limited to cytokine-cytokine receptor interaction and MAPK signaling pathway. A PPI network consisting of 188 nodes and 563 edges was constructed using STRING, and 27 hub genes were identified with Cytoscape software. The miRNA-mRNA network with high connectivity contained key 27 mRNAs (from C-C motif chemokine ligand 5 (CCL5), C-C motif chemokine ligand 8 (CCL8), …., to dishevelled-associated activator of morphogenesis 1 (DAAM1), and FRAT regulator of WNT signaling pathway 1 (FRAT1)) and 135 candidate miRNAs. These genes and miRNAs are closely related to secondary brain injury induced by ICH. In addition, a L1000CDS&lt;sup&gt;2&lt;/sup&gt; analysis of six small-molecule compounds revealed their therapeutic potential.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Our study explores the pathogenesis of brain tissue injury promoted by neuroinflammation in ICH and extends the clinical utility of its key genes. At the same time, we constructed a miRNA-mR","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 1-13"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mixed-reality head-mounted display in cranial neurosurgery: A proof-of-concept study","authors":"Lukas Andereggen ,&nbsp;Gwendoline Boillat ,&nbsp;Joshua Haegler ,&nbsp;Philipp Gruber ,&nbsp;Basil Erwin Grüter ,&nbsp;Stefan Wanderer ,&nbsp;Angelo Tortora ,&nbsp;Gerrit A. Schubert ,&nbsp;Hans-Jakob Steiger ,&nbsp;Serge Marbacher","doi":"10.1016/j.hest.2024.07.003","DOIUrl":"10.1016/j.hest.2024.07.003","url":null,"abstract":"<div><h3>Objective</h3><div>Mixed-reality (MR) head-mounted displays (HMD) offer virtual augmentations registered with real objects, allowing for direct patient-centered lesion visualization. In contrast to other surgical subspecialties, however, the application of MR in neurosurgery remains poor. In this proof-of-concept study, we aimed at evaluating the applicability, educational value, and accuracy of HMD as compared to standard neuronavigation (SN) in the planning of treatment for patients undergoing neurovascular and tumor surgeries.</div></div><div><h3>Methods</h3><div>A 3D hologram of the patient’s anatomy was generated from conventional CT scan, MRI, and/or 3D rotational angiography (3D-RA), and integrated into the HMD. The participating surgeons completed a standardized questionnaire, which evaluated the application of HMD compared to SN, to detail the visualization benefits and limitations of the 3D hologram.</div></div><div><h3>Results</h3><div>Eight consecutive patients with neurovascular (n = 4) or tumor pathologies (n = 4) were selected for MR. The mean (±SD) setup time was significantly longer for HMD than SN (8.3 ± 1.5 min vs. 4.8 ± 1.3 min; <em>p</em> &lt; 0.001), independent of the pathology applied (i.e., tumor: 8.0 ± 2.0 vs. 4.3 ± 1.3, <em>p</em> = 0.02, and vascular: 8.7 ± 0.9 vs. 5.4 ± 1.1; <em>p</em> &lt; 0.001). Surgeons wearing the HMD succeeded in moving the 3D hologram from respective operators’ angles and identifying the shape and configuration of the lesion. The MR device was superior to SN with regard to treatment planning on account of its improved spatial awareness. The current method is however limited in its representation of small perforators in neurovascular pathologies and bony involvement in tumors.</div></div><div><h3>Conclusions</h3><div>MR may become a valuable tool in the preoperative treatment planning, education and guidance of complex procedures in selected patients, yet further development is necessary to improve the clinical applicability of the MR HMD.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 24-29"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of bilateral vertebral artery dissecting aneurysms presenting with subarachnoid hemorrhage evaluated using computational fluid dynamics: Which is the rupture side?","authors":"Masanori Tsuji ,&nbsp;Fujimaro Ishida ,&nbsp;Ryuta Yasuda ,&nbsp;Tomonori Ichikawa ,&nbsp;Takenori Sato ,&nbsp;Kazuhiro Furukawa ,&nbsp;Yoichi Miura ,&nbsp;Yasuyuki Umeda ,&nbsp;Naoki Toma ,&nbsp;Hidenori Suzuki","doi":"10.1016/j.hest.2024.04.006","DOIUrl":"10.1016/j.hest.2024.04.006","url":null,"abstract":"<div><div><em>Background:</em> Saccular aneurysms (SAs) have been long studied in hemodynamics using computational fluid dynamics (CFD), while dissecting aneurysms (DAs) remain unclear. To estimate which side of the aneurysm ruptured, we evaluated the hemodynamics of the bilateral vertebral artery DAs (VADAs).</div><div><em>Case presentation:</em> A 44-year-old male was diagnosed with subarachnoid hemorrhage by the rupture of either side of bilateral VADAs. The rupture side could not be determined on admission (Day 0). CFD was performed using a patient-specific geometry model obtained from 3-demensional (3D) rotational angiography (RA) on day 1. We predicted that the right DA had ruptured based on the hemodynamics, associated with flow stagnation and complexity in the ruptured SAs by a transient analysis with the patient-specific blood flow velocity waveforms. After careful observation, gadolinium-enhanced MRI on day 16 showed a contrast effect in the right wall and a change in the right shape was confirmed on the second 3D RA on day 17. According to both imaging evaluations and CFD, the right was presumed to be ruptured, and a flow-diverter stent was placed at the right VA. The right VADA did not re-rupture for 12 months.</div><div><em>Conclusion:</em> Our results indicated that hemodynamics of ruptured DAs would be similar to that of ruptured SAs.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 57-60"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}