Cerebral vasospasm following clipping of unruptured middle cerebral artery aneurysms: a case report and literature review

We report a 64-year-old woman who developed symptomatic vasospasm on postoperative day 7 after clipping of an unruptured right middle cerebral artery (MCA) aneurysm. Imaging revealed right MCA vasospasm, which resolved with oral antiplatelets and intravenous vasodilators. She was discharged without neurological deficits. Although a few reports describe vasospasm after clipping unruptured aneurysms, this is the first to detail the clinical course, radiological findings, and treatment response. Potential risk factors include female sex, age 40-60, smoking, trigeminal neuralgia, and complex aneurysms. This case underscores the need to consider vasospasm even without subarachnoid hemorrhage for timely intervention.