Cerebral vasospasm: a clinical observation

Three cases of subarachnoid hemorrhage from intracranial aneurysms are presented. Two of the patients survived long enough to develop delayed cerebral vasospasm. The computerized tomograms and angiograms were correlated with the clinical course. It is suggested that delayed cerebral vasospasm may be preceded by relative vasodilation, or at least inhibition of vasocontraction, and concomitant increased vascular permeability of the parent vessels diagnosed by contrast enhanced computerized tomography. This phenomenon, if confirmed in larger series of patients, may allow prediction of that patient destined for vasospasm and may suggest some of the pathophysiology of this devastating problem.