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. Author manuscript; available in PMC: 2012 Jul 5.
Published in final edited form as: Imaging Med. 2011 Jun 1;3(3):287–297. doi: 10.2217/iim.11.19

Figure 5. A 66-year-old female with ruptured anterior communicating artery aneurysm and acute subarachnoid hemorrhage.

Figure 5

(A) Posterior–anterior projection of the right internal carotid artery on post-hemorrhage day 1, at the time of aneurysm coiling, shows normal caliber of the M1 segment of the right middle cerebral artery and no evidence of vasospasm. The A1 segment of the right anterior cerebral artery is hypoplastic (black arrow). (B) CT perfusion examination performed on post-hemorrhage day 9, after the patient developed a left-sided pronator drift. There is delayed mean transit time (bottom right image), decreased cerebral blood flow (bottom left image) and preserved cerebral blood volume (top right image) in the right middle cerebral artery territory, consistent with a perfusion deficit (white arrows). (C) Emergent digital subtraction angiography performed just after the CT perfusion examination shows significant vasospasm of the M1 and M2 segments of the right middle cerebral artery (black arrow). The patient was treated with intra-arterial verapamil and experienced marked improvement, both clinically and on post-verapamil angiography.