A, Ruptured distal carotid artery aneurysm of a 72-year-old man with acute SAH, Hunt and Hess 4. B, After endovascular treatment with Guglielmi detachable coils (Boston Scientific). C–F, ACT images (C and E) show the SAH and IVH as well as dilation of the supratentorial ventricular system. In contrast to MDCT (F), the fourth ventricle cannot be evaluated in the ACT examination (E) due to beam hardening artifacts. After implantation of a lumbar drain, follow-up MDCT scans (D and F) show a slight decrease of the lateral ventricle size.