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Subarachnoid hemorrhage from a ruptured intracranial aneurysm causes death or disability in many patients. About 70% develop vasospasm, and 40% experience infarction with or without vasospasm. Treatment of vasospasm with calcium-channel blockers does not affect large brain vessels and does not reduce mortality but lessens poor outcome by one third. The objective of this study was to examine the effectiveness of early lumbar cerebrospinal drainage after aneurysmal subarachnoid hemorrhage. This was a multicenter, parallel-group, open-label randomized clinical trial in 19 hospitals in Germany, Switzerland, and Canada. Of 287 included patients (68% female; median age, 55 years), 144 were randomized, after aneurysm coiling or clipping, to receiv…