Structure, mechanical properties, and mechanics of intracranial saccular aneurysms

Intracranial saccular aneurysms remain an enigma; it is not known why they form, why they enlarge, or why only some of them rupture. Nonetheless, there is general agreement that mechanics plays an essential role in each aspect of the natural history of these potentially deadly lesions. In this paper, we review recent findings that discount limit point instabilities under quasi-static increases in pressure and resonance under dynamic loading as possible mechanisms of enlargement of saccular aneurysms. Indeed, recent histopathological data suggest that aneurysms enlarge due to a stress-mediated process of growth and remodeling of collagen, the primary load-bearing constituent within the wall. We submit that advanced theoretical, experimental, and numerical studies of this process are essential to further progress in treating this class of pathologies. The purpose of this review is to provide background and direction that encourages elasticians to contribute to this important area of research.