A left pterional decompressive craniectomy has been performed with clips in the region of the left MCA bifurcation. Stable large volume of subarachnoid haemorrhage with haematoma filling and expanding the left sylvian fissure. There is progressive surrounding hypodensity involving the adjacent insular cortex, temporal lobe and posterior left frontal lobe. Mass effect continues to distort the left lateral ventricle and cause uncal herniation. The right temporal horn is more prominent than on the previous study in keeping with developing hydrocephalus. Blood continues to pool in the occipital horns of the lateral ventricles, within the third and the fourth ventricles as well as the basal cisterns.
No residual filling of the previously demonstrated left MCA bifurcation aneurysm identified. Anterior pointing right MCA bifurcation 4.5 x 3.5 mm aneurysm again demonstrated.