Complete obliteration of the aneurysm is recommended whenever possible. B 12. For patients with ruptured aneurysms judged to be technically amenable to both endovascular coiling and neurosurgical clipping, endovascular coiling should be considered. B* 13. In the absence of a compelling contraindication, patients who undergo coiling or clipping of a ruptured aneurysm should have delayed follow-up vascular imaging (timing and modality to be individualized), and strong consideration should be given to retreatment, either by repeat coiling or microsurgical clipping, if there is a clinically significant (eg, growing) remnant. B 14. Low-volume hospitals (eg, 10 aSAH cases per year) should consider early transfer of patients with aSAH to high-volume centers (eg, 35 aSAH cases per year) with experienced cerebrovascular surgeons, endovascular specialists, and multidisciplinary neuro-intensive care services. B 15. Maintenance of euvolemia and normal circulating blood volume is recommended to prevent DCI. B 16. Induction of hypertension is recommended for patients with DCI unless blood pressure is elevated at baseline or cardiac status precludes it. B 17. aSAH-associated acute symptomatic hydrocephalus should be managed by cerebrospinal fluid diversion (EVD or lumbar drainage, depending on the clinical scenario). B* 18. Heparin-induced thrombocytopenia and deep venous thrombosis, although infrequent, are not uncommon occurrences after aSAH. Early identification and targeted treatment are recommended, but further research is needed to identify the ideal screening paradigms. C 1. Determination of aneurysm treatment, as judged by both experienced cerebrovascular surgeons and endovascular specialists, should be a multidisciplinary decision based on characteristics of the patient and the aneurysm. C 2. aSAH-associated chronic symptomatic hydrocephalus should be treated with permanent cerebrospinal fluid diversion. aSAH indicates aneurysmal subarachnoid hemorrhage; CT, computed tomography; DSA, digital subtraction angiography; DCI, delayed cerebral ischemia; and EVD, external ventricular drainage. *A new recommendation. 