A prototypical example of a 34-y-old female with aSAH. (A) Noncontrast head CT showing diffuse Fisher 3+4 SAH and layering intraventricular hemorrhage. (B) Initial cerebral angiography of the right internal carotid artery (ICA) demonstrates a right posterior communicating artery aneurysm. (C) Repeat cerebral angiography posttreatment by coiling. (D) At day 6 postcoiling, the patient developed progressive confusion and stupor with a left hemiparesis. Cerebral angiography demonstrates severe right M1 and moderate right M2 and A2 CV. (E) Following intra-arterial infusion of verapamil, there is minimal change in the degree of CV. (F) Angioplasty is performed. A balloon is inflated in the right M1. (G) There is significant improvement of the right M1 CV following angioplasty. (H) Angiography of the left ICA shows moderate left A1, A2, and M2 CV, which was treated with intra-arterial verapamil infusion only.