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A 42 year old man developed left lower leg weakness one week after successful coiling of an anterior communicating artery aneurysm which had bled..
Cerebral angiogram of the right internal carotid artery (Right) AP view; (Left) Lateral view. Note the severe narrowing of the left anterior cerebral artery. Also note on the lateral view, the relative absence of any flow in the anterior cerebral artery territory This is vasospasm, a known delayed complication of SAH. If severe enough, vasospasm may lead to progressive ischemia and stroke (see the patient's CT scan). In some cases, an acute stroke then results in edema, herniation and death. Vasospasm is typically treated with volume expansion, mild evaluation of BP, and in some case, angioplasty of the involved blood vessels.
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