Low frequency flow fluctuations in saccular aneurysms.

Intra-operative Doppler recordings were carried out on cerebral saccular aneurysms in 12 patients. Distinct fluctuations of flow superimposed on the pulse wave were seen in 6 patients. The fluctuations appeared to be periodic with measured period lengths of 60 to 150 msec. In 3 other patients flow irregularities could be discerned acoustically but a definite periodicity could not be visualized on screen. In 3 patients flow appeared smooth during the entire pulse cycle, acoustically as well as visually. Concomitant flow observations in glass model aneurysms also revealed flow instabilities in certain aneurysm types at a Reynold's number of 300. All observed irregularities of flow were observed in zones of deceleration of flow in the models. Signs of fully developed turbulence were not found, neither in human aneurysms nor in the glass models. It appears likely that the fluctuations of flow induce vibrations of the aneurysmal wall and contribute to aneurysm progression and eventual rupture.