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Figure 2: Clip remodeling of a ruptured Fisher grade 3 blister aneurysm followed by severe vasospasm and delayed cerebral ischemia. The patient is a 43-year-old woman who complained of a severe headache since the prior day and presented with a Hunt and Hess 2, Fisher 3 subarachnoid hemorrhage (a) from a ruptured right internal carotid artery trunk blister aneurysm (b and c). Patient underwent a right frontotemporal craniotomy and clip approximation of the normal edges of the defect (d). On hospital day 6, she developed severe right-sided vasospasm (e), was placed on induced hypertension therapy and underwent daily intra-arterial verapamil injections. Despite therapy, she progressed to a large right-sided stroke with midline shift and underwent a right hemicraniectomy on hospital day 8 (f). A right cranioplasty was performed 8 months later, and she recovered to modified Rankin scale 4

Figure 2: Clip remodeling of a ruptured Fisher grade 3 blister aneurysm followed by severe vasospasm and delayed cerebral ischemia. The patient is a 43-year-old woman who complained of a severe headache since the prior day and presented with a Hunt and Hess 2, Fisher 3 subarachnoid hemorrhage (a) from a ruptured right internal carotid artery trunk blister aneurysm (b and c). Patient underwent a right frontotemporal craniotomy and clip approximation of the normal edges of the defect (d). On hospital day 6, she developed severe right-sided vasospasm (e), was placed on induced hypertension therapy and underwent daily intra-arterial verapamil injections. Despite therapy, she progressed to a large right-sided stroke with midline shift and underwent a right hemicraniectomy on hospital day 8 (f). A right cranioplasty was performed 8 months later, and she recovered to modified Rankin scale 4