Relevance of diffusion and perfusion weighted MRI for endovascular treatment of vasospasm in subarachnoid hemorrhage

The endovascular treatment of vasospasm is effective when implemented rapid ly. However its indication often proves difficult on account of the lack of diagnostic arguments or the difficulties in obtaining them in daily practi ce. We report a case that highlights the relevance of MRI in the decision-m aking process. A 37-year-old patient presented with symptomatic vasospasm of the middle ce rebral artery and was subjected to morphological, diffusion- and perfusion- weighted MRI. These investigations confirmed the presence of significant ol igemia in the MCA territory and revealed onsetting diffusion disorders. Ang ioplasty was immediately performed, resulting in normal diffusion and hemod ynamic parameters and complete regression of clinical signs. This case highlights the relevance of MRI when assessing vasospasm before t reatment. Coupled with transcranial Doppler, it should help teams quickly s elect patients most likely to benefit from angioplasty.