Objective: Subarachnoid clots are important in development of delayed vasospasm after subarachnoid hemorrhage (SAH). The purpose of this study was to define the association between the subarachnoid clot volume and the incidence of symptomatic vasospasm (SV) after surgical clipping and embolization with Guglielmi detachable coils (GDCs) for aneurysmal SAH. Methods: The subjects were 155 patients with aneurysmal SAHs that were detected with a CT scan at admission and were treated by surgical clipping (Clip group, n=112) or GDC embolization (Coil group, n=43) within 72 hours of ictus between January 22, 2002 and November 22, 2009. Software-based volumetric quantification of the subarachnoid clot was performed using the voxel count method (AZE Virtual Place Fujin Raijin, AZE Ltd.). Subarachnoid clot was defined as cisternal high density areas with a Hounsfield number from 43 to 90 in the CT scan. Results: SV occurred in 24.1% and 16.3% of the patients in the Clip group (age, 63.5±12.8; male, 33.9%) and the Coil group (age, 63.0±12.6; male, 18.6%), respectively. The area
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