===== 🧬 Aneurysm Formation ===== Intracranial aneurysms are pathological dilations of the cerebral arterial wall, typically occurring at **arterial bifurcations** where **hemodynamic stress** is concentrated. ==== 🧠 Hemodynamic Contributors ==== Computational fluid dynamics (CFD) studies suggest that the following factors may contribute to aneurysm initiation: * **High wall shear stress (WSS)** → may damage endothelial cells * **Flow bifurcations** → increase mechanical stress on vessel walls * **Complex or unstable flow patterns** → lead to endothelial dysfunction * **Low WSS zones** → promote inflammation, wall remodeling and degeneration ==== 🧩 Biological Mechanisms ==== CFD findings are integrated with biological hypotheses: * **Endothelial injury** triggers inflammatory cascades * **Smooth muscle cell apoptosis** weakens wall structure * **Matrix degradation** via MMPs (matrix metalloproteinases) * **Genetic predisposition** may modulate vulnerability ==== 📌 Typical Locations ==== * Anterior communicating artery (ACoA) * Posterior communicating artery (PCoA) * Middle cerebral artery (MCA) bifurcation * Internal carotid artery (ICA) siphon