The study showed that hypother- mia was relatively safe but was not associated with a beneficial effect in mortality or neurological outcome among patients with good-grade aSAH.189 In addition, intraoperative hypothermia had no beneficial effect on neuropsychological function after SAH.190 Of note, the power of these 2 studies was not sufficient to detect more modest benefits from hypothermia, and there were some trends in favor of hypo- thermia for secondary end points. Temporary clipping is frequently used to improve surgical conditions and prevent intraoperative rupture during the surgical dissection of aneurysms. In a retrospective study, outcome was not affected by temporary vascular occlusion.191 Induced hypertension can be considered when the duration of temporary clipping is expected to be 120 seconds, but the value of this strategy has not been well studied in aneurysm surgery. In selected patients with giant aneurysms, deep hypothermia with circulatory arrest under cardiopulmonary extracorporeal circulation has been shown to be a feasible and possibly useful technique, but outcome data are lacking.192 196 Transient cardiac pause induced by adenosine has been used to control bleeding from intraoperative aneu- rysm rupture or to decompress large aneurysms and facilitate aneurysm clip application197,198; however, controlled studies are needed to validate this intervention. There is little information in the literature about anesthetic management of patients undergoing endovascular treatment of ruptured cerebral aneurysms.199 201 Generally, the anes- thetic principles that apply to open surgical treatment of ruptured cerebral aneurysms also apply to endovascular treatment. The choice of anesthetic technique varies depend- ing on the institution, with the most common techniques being conscious sedation and general anesthesia.202 204 There have been no studies comparing these 2 techniques. 