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7 mm pseudoaneurysm. TCCD showed very high velocities in the RMCA. The Breath-Holding Index (BHI) was 0.56, suggestive of reduced CVR in the RMCA territory. Acetazolamide-enhanced single-photon emission CT showed reduced right frontal CVR. She was given clopidogrel for secondary prevention, and has remained well. BHI as measured by TCCD is a new method for assessing CVR in patients with cerebral ischemia.Delayed cerebral ischaemia (DCI) and cerebral infarction is a much-feared complication of aneurysmal subarachnoid haemorrhage (aSAH).

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