Marked morphologic change of cerebral vessel with coexistence of severe flow compromise during endovascular treatment for ruptured aneurysm

In the vasospasm periods, the optimal timing of treatment for ruptured intracranial aneurysms remains controversial. In generally, it was recommended that treatment for a ruptured aneurysm be delayed until its disappearance, but this might be associated with aneurysmal re-rupture resulting in a poor outcome. Endovascular technique has been developed for many years, early treatment after aneurysmal subarachnoid hemorrhage (SAH) seems to be technically feasible even in the period of severe vasospasm. The present cases report our experiences of endovascular treatment for ruptured aneurysm in the presence of severe angiographic vasospasm and discuss the pertinent controversy.