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Fig 2. Patient transferred to our neurovascular ICU from an outside institution at day 4 after rupture of an ACom aneurysm (arrow). Admission TCD ultrasonography demonstrated increased absolute FV of 135 cm/s in ACAs. A CTA and PCT survey were obtained to rule out vasospasm; the PCT was completely normal and the CTA demonstrated the ACom aneurysm (arrow), but no vasospasm. DSA was performed determine the configuration of the aneurysm and to determine the best therapeutic strategy (endovascular coiling vs neurosurgical clipping). It confirmed the absence of vasospasm. TCD false-positive results were most likely related to the triple H (hypertensive, hypervolemic, hemodilutional) therapy undergone by the patient at the time of the TCD examination.
