Severe Diffuse Vasospasm: B/L Intraarterial Vasodilatation Followed by Coiling
A 35-year-old female had sudden severe headache without associated neurological deficits. Although CT scan revealed diffuse SAH, she was treated conservatively. Ten days after the ictus she became drowsy and was shifted to our hospital. At the time of admission, she had right hemiparesis with a score of E3M5V1 on the Glasgow coma scale. Repeat CT scan revealed residual SAH (Fig. 55.1a) and left frontal infarct (Fig. 55.1b). DSA revealed severe vasospasm of B/L ACAs in the A1 and A2 segments (Fig. 55.2c–f) and the left MCA. A very small aneurysm was discernible in the ACOM region.