https://doi.org/10.1140/epjs/s11734-026-02241-x
Regular Article
Elevated wall shear stress in middle cerebral arteries following severe traumatic brain injury: a biophysical analysis in diffuse and focal injury patterns
1
Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
2
Clinical Hospital 10, Nizhny Novgorod, Russia
3
Department of Biology, Saratov State University, Saratov, Russia
4
Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM, USA
5
Lovelace Biomedical Research Institute, Albuquerque, NM, USA
6
Department of Physiology, New York Medical College, Valhalla, NY, USA
a
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Received:
24
December
2025
Accepted:
27
February
2026
Published online:
17
April
2026
Abstract
Severe traumatic brain injury (sTBI) disrupts cerebral hemodynamics, yet the biomechanical consequences on arterial wall shear stress (WSS) remain poorly understood. The aim was to assess the changes in wall shear stress in the middle cerebral artery (WSSmca) in severe traumatic brain injury (sTBI) patients with and without the development of intracranial hematomas (ICH). A total of 78 patients with sTBI (mean age 35.1 ± 7.3 years, 40 men, 38 women) were enrolled. Group 1 included 39 patients without ICH, and Group 2 included 39 patients after surgical removal of peradural (epidural or subdural) ICH. Computed tomography and transcranial Doppler were performed 2–5 days after TBI. WSSmca was calculated using the Hagen–Poiseuille’s equation. Statistical analysis was performed using the T-Student’s test to compare WSSmca between the ICH-ipsilateral and ICH-contralateral hemispheres. Data are presented as mean ± SD, with significance set at p < 0.05. Wall shear stress in M1 segments of MCAs significantly exceeded the reference range (3.64 ± 1.25 Pa) in both groups (p < 0.05). In Group 1, mean WSSmca was 4.27 ± 0.23 Pa. In Group 2, WSSmca was significantly higher on the ipsilateral side (6.29 ± 0.47 Pa) and contralateral side (5.38 ± 0.61 Pa) compared to Group 1 (p < 0.001). Ipsilateral previously removed ICH WSSmca in Group 2 was also significantly higher than contralateral WSSmca (p = 0.008). Elevated WSS persists after ICH evacuation, suggesting sustained biomechanical stress on arterial walls. These findings highlight shear-mediated contributions to secondary cerebrovascular injury in sTBI and warrant further biophysical investigation.
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© The Author(s), under exclusive licence to EDP Sciences, Springer-Verlag GmbH Germany, part of Springer Nature 2026
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
