This study shows the influence of the upstream parent artery geometry on intra-aneurysmal hemodynamics of cerebral aneurysms. Patient-specific models of four cerebral aneurysms at four typical locations were constructed from 3D rotational angiography images. Two geometrical models were constructed for each patient, one with the native parent vessel geometry and another with the parent vessel truncated approximately 1cm upstream from the aneurysm. For one aneurysm, two images were used to construct a model as realistic and large as possible - down to the carotid bifurcation - which was cut at seven different locations. Corresponding finite element grids were generated and computational fluid dynamics simulations were carried out under pulsatile flow conditions. It was found that truncated models tended to underestimate the wall shear stress in the aneurysm and to shift the impaction zone to the neck when compared with the native geometry. In one aneurysm the parent vessel included a tortuous segment close to the neck that strongly influenced the flow pattern entering the aneurysm. Thus, including longer portions of the parent vessel beyond this segment did not have a substantial effect. Depending on the dominant geometrical features the length of the parent artery needed for an accurate representation of the intraaneurysmal hemodynamics may vary among individuals. In conclusion, failure to properly model the inflow stream determined by the upstream parent artery can significantly influence the results of intra-aneurysmal hemodynamic models. The upstream portion of the parent vessel of cerebral aneurysms should be included in order to accurately represent the intraaneurysmal hemodynamics.© (2006) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.