FIG 1. A and B, MR angiograms (32/8/2; flip angle = 17°) obtained 1 (A) and 10 (B) days after acute SAH. At day 1, all vessels are normal (rating = 0); at day 10, a severe vasospasm is identified in both the ACA (rating = 3 bilaterally) and in the right MCA (rating = 3). In the left MCA, the narrowing is moderate (rating = 2) and a slight narrowing of both ICAs was also recorded (rating = 1 bilaterally) (not shown). The distal segments of arteries are poorly visualized, and the overall quality of MR angiography looks poor. These findings are typical of severe vasospasm and are related to the decreased flow into spastic vessels.

C, IA-DSA (right carotid arteriogram) obtained 9 days after SAH and 15 hours before MR angiography (B). Note presence of severe vasospasm (rating = 3 for the ACA and 2 for the MCA and ICA). Correlation with MR angiography was excellent for the ACA and good for the MCA and ICA.