The latest edition of AJNR (Nov-Dec 2010) has two poignant and very important articles in it
see AJNR -- Table of Contents (31, [10])
1st article I recommend is
A.C. Mamourian, H. Young, and M.F. Stiefel
Cumulative Radiation Dose in Patients Admitted with Subarachnoid Hemorrhage:
 A Prospective Study Using a Self-Developing Film Badge 
AJNR Am J Neuroradiol 2010 31: 1787-1790 originally published online on July 1 2010, 10.3174/ajnr.A2192 . [Abstract] [Full Text] [Figures Only] [PDF]  
The cumulative radiation to SAH patient is very high with serial CT scans, diagnostic angiograms
 (CTA/DSA), coiling, chest radiographs etc.
The authors have given a value of upto 1.8 Gy, however in practice, in may instances this is sure
 to exceed especially
if redo interventions, interventions for vasospasm and repeated check angiograms are needed.
From 3 Gy onwards, depilation starts, at 2 Gy erythema starts, and out doses are not very from
 this value.
There has to be more better techniques for reducing the dosage during these procedures.
However, till the technology is not available, we must be very selective and careful in our usage
 of x-ray based machines.


2nd  article is
P. Jun, N.U. Ko, J.D. English, C.F. Dowd, V.V. Halbach, R.T. Higashida, M.T. Lawton, and S.W. Hetts
Endovascular Treatment of Medically Refractory Cerebral Vasospasm Following Aneurysmal Subarachnoid Hemorrhage
AJNR Am J Neuroradiol 2010 31: 1911-1916 originally published online on July 8 2010, 10.3174/ajnr.A2183 . [Abstract] [Full Text] [Figures Only] [PDF]  




SAH leads to vasospasm in 25-30% patients, and leads to prolonged morbidity and poor neurological outcome
 and even death in few.
Traditional treatment with Triple H therapy is helpful many a times, however, endovascular treatment is needed
 sometimes.
The authors have discussed in detail this very important component of SAH management.


Another article in this edition also discusses usage of intra arterial verapamil for vasospam treatment.