Non-Kolmogorov Turbulence and Inverse Energy Cascade in Intracranial Aneurysm: Near-Wall Scales Suggest Mechanobiological Relevance

The genesis, growth and rupture of intracranial aneurysm (IA) are open questions in neurovascular medicine until the present moment. The complexity of aneurysm mechanobiology and pathobiology staggeringly combine intertwining biological and physical processes that are tightly connected. Recently, transition to turbulence in IA blood flow is thought to play a central role in IA growth and rupture as it can be directly linked to endothelial dysfunction. However, the problem of turbulence brings unprecedented complications to the topic. We found turbulence in IA to be of non-Kolmogorov type. For the first time, we detected inverse kinetic energy cascade in blood flow and in non-Kolmogorov turbulence. Here, we hypothesize that the near-wall turbulence undergoing inverse energy cascade have scales that could affect the mechano-signaling of endothelial cells. Our findings could be a paradigm shift in the contemporary theory of aneurysm hemodynamics.