Data obtained from consecutive patients with aSAH using historical controls to compare aggressive versus stan- dard management of hyperglycemia suggest that effective glucose control after aSAH can significantly reduce the risk of poor outcome in these patients.324 Nevertheless, even serum glucose levels within the normal range may be asso- ciated with brain energy metabolic crisis and lactate-pyruvate ratio elevation in patients with poor-grade aSAH.325 Anemia is common after aSAH and may compromise brain oxygen delivery.326 Transfusion of red blood cells in anemic patients with aSAH results in a significant rise in cerebral oxygen delivery and a reduction in oxygen extraction ratio.327 Data obtained from prospective registries of patients with aSAH suggest that higher hemoglobin values are associated with improved outcomes after aSAH.328,329 Nevertheless, thresholds for blood transfusion have been dictated in a nonsystematic manner and have therefore varied widely. Furthermore, red blood cell transfusions, as used in daily practice, have been associated with worse outcomes in aSAH in some series.330,331 Recently, a prospective randomized trial has shown the safety and feasibility of keeping a higher hemoglobin goal in patients with aSAH who are at high risk of vasospasm.332 The optimal hemoglobin goal after aSAH is not yet known, however. Two additional medical complications are heparin-induced thrombocytopenia333 335 and deep venous thrombosis. With regard to the former, the incidence, based on 3 single-center series, is likely 5% and does not appear to be related to the use of heparin for deep venous thrombosis prophylaxis, but rather to the number of angiographic procedures performed. Patients with heparin-induced thrombocytopenia type II appear to have higher rates of thrombotic complications and symptom- atic vasospasm/DCI, more deaths, and significantly less favor- able outcomes. 