Interval changes of left craniectomy with clipping of the ACoM aneurysm (red arrow @Key Finding 1). The craniectomy was likely performed because of the new parenchymal hematoma in the left temporal lobe with surrounding edema (blue arrow @Key Finding 1). There is some herniation of injured and edematous brain parenchyma through the craniectomy defect.

Multifocal vasospams is seen. Axials show the severe spasm of the left ICA (@Key Finding 2) and basilar artery (@Key Finding 3) well. MIP images can be very valuable as well, showing the left ICA, MCA, and ACA spams (@Key Finding 4) as well as the bilateral right greater than left PCA spasm (@Key Finding 5).