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Abstract

Delayed cerebral ischemia (DCI) is a common complication associated with subarachnoid hemorrhage (SAH) and is strongly correlated with significant morbidity and mortality. In order to prevent the deleterious effects of this pathology, a strategy of early detection and intervention is vital. There are a variety of imaging options that are employed to achieve these objectives. These include computed tomographic (CT) angiography (CTA), CT perfusion (CTP), transcranial doppler ultrasound (TCD), and digital subtraction angiography (DSA). According to the consensus opinion, each imaging method has strengths and weaknesses. For example, CTA and CTP are minimally invasive but require radiation exposure and contrast dosing. TCD is lower in cost and invasiveness but lacks specificity and DSA although the most invasive--is considered the gold standard for both detection and treatment. At the setting in question, there did not appear to be a consistent utilization of these imaging modalities for vasospasm monitoring.

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