Moder n Imaging of Aneurysmal Subarachnoid Hemorrhage

Neuroimaging is essential in both the diagnosis and management of SAH. An NCCT remains the mainstay of initial diagnosis and patients with thunderclap headache or headache with new neurologic deficits, but negative NCCT should un-dergo further evaluation with CTA, LP, or MR im-aging. Image acquisition and post-processing advancements, including the use of AI are making CTA and MRA aneurysm detection more effective. However, patients with SAH and negative noninva-sive imaging still require a DSA for definitive diag-nosis. Lastly, once the diagnosis and initial treatments have been completed, patients must be monitored for DCI through a combination of screening with TCDs and the physical examination and prudent use of perfusion imaging. New research focusing on cerebral oxygen delivery and imaging modalities that help predict outcomes in SAH may help clinicians more effectively apply resources to benefit.