aSAH indicates aneurysmal subarachnoid hemorrhage; CT, computed tomography; DSA, digital subtraction angiography; DCI, delayed cerebral ischemia; and EVD, external ventricular drainage. *A new recommendation. A change in either level of evidence or strength of the recommendation from previous guidelines. Connolly et al Management of Aneurysmal Subarachnoid Hemorrhage 1715 Table 4. New or Revised Recommendations New or Revised Recommendation Class of Recommendation/ Level of Evidence New 1. In addition to the size and location of the aneurysm and the patient s age and health status, it might be reasonable to consider morphological and hemodynamic characteristics of the aneurysm when discussing the risk of aneurysm rupture. Class IIb, Level B New 2. Consumption of a diet rich in vegetables may lower the risk of aSAH. Class IIb, Level B New 3. After any aneurysm repair, immediate cerebrovascular imaging is generally recommended to identify remnants or recurrence of the aneurysm that may require treatment. Class I, Level B New 4. After discharge, it is reasonable to refer patients with aSAH for a comprehensive evaluation, including cognitive, behavioral, and psychosocial assessments. Class IIa, Level B New 5. CTA may be considered in the workup of aSAH. If an aneurysm is detected by CTA, this study may help guide the decision for the type of aneurysm repair, but if CTA is inconclusive, DSA is still recommended (except possibly in the instance of classic perimesencephalic SAH). Class IIb, Level C New 6. Magnetic resonance imaging (fluid-attenuated inversion recovery, proton density, diffusion-weighted imaging, and gradient echo sequences) may be reasonable for the diagnosis of SAH in patients with a nondiagnostic CT scan, although a negative result does not obviate the need for cerebrospinal fluid analysis. Class IIb, Level C New 7. 