Vasospasm is defined by narrowing of the blood vessel diameter. This can
lead to tissue death (necrosis). Cerebral vasospasms may arise in the context
of subarachnoid hemorrhage. The blood vessels react to subarachnoid
hemorrhage with vessel wall thickening and muscular spasm, resulting in
severe decrease of caliber and flow. Vasospasm is a major contributor to
postoperative stroke and death after brain injury, aneurysm repair and any
other source bleeding within the brain. Vasospasm may not appear until four
to eight days after injury.

CT shows extensive subarachnoid hemorrhage.

CTA shows right sided posterior communicating irregular aneurysm.

Post clipping angiogram shows severe spasm of the carotid and middle
cerebral arteries. The patient developed new weakness.

Intraprocedural angiogram shows balloon cathether inflated in the M1
segment of the MCA.

Final angiogram shows marked increase in the vessel caliber.