[Verse 1] A berry hangs where vessels fork and bifurcate, Saccular walls grown thin at points of turbulent fate, Polycystic kidneys, Ehlers-Danlos, coarctation's pull, Fibromuscular dysplasia stretching collagen dull, PHASES score and ISUIA weigh the silent threat, Size and location, population, smoking history set, Under seven millimetres, unruptured, watch and wait, But growth on surveillance demands we recalibrate [Chorus] Diagnose, triage, secure, and salvage every case, Hunt and Hess and Fisher — grade before you place, Thunderclap and xanthochromia, LP if CT's clean, ISAT and BRAT together paint the treatment scene, Coil or clip, decide by morphology and clot, Protect the perforators — that's the part you cannot slot [Verse 2] The sentinel bleed, a premonitory whisper of the main event, Then thunderclap erupts — a cataclysm heaven-sent, CT in the first six hours catches ninety-eight percent, After that the cerebrospinal fluid tells you where it went, Xanthochromia bilirubin-stained, spectrophotometry clear, VASOGRADE predicts the vasospasm you've already begun to fear, Rebleed kills within the first twenty-four, Blood pressure under one-forty, antifibrinolytics before the door, ULTRA trial said short-course is the safer call, EVD for hydrocephalus before the pressure makes them fall [Chorus] Diagnose, triage, secure, and salvage every case, Hunt and Hess and Fisher — grade before you place, Thunderclap and xanthochromia, LP if CT's clean, ISAT and BRAT together paint the treatment scene, Coil or clip, decide by morphology and clot, Protect the perforators — that's the part you cannot slot [Bridge] Neurogenic stunned myocardium — the catecholamine storm, Pulmonary oedema floods the alveoli warm, Hyponatremia drops beneath a cerebral salt-wasting tide, Isotonic saline, careful not to shift too wide, The word for it is *fulgurant* — sudden, searing, absolute — Like the rupture itself, no gradual in that root [Verse 3] Pterional craniotomy, sylvian fissure split with care, Orbitozygomatic for the high basilar sitting there, Proximal control established, temporary clip applied, Four minutes safe duration — adenosine for the tide, Rapid ventricular pacing if the dome won't still, Intraoperative rupture — suction, clip, and iron will, ICG and micro-Doppler verify the flow is true, Perforators draped like lacework — every one comes through [Verse 4] Endovascular — coil the dome, balloon remodels the neck, Stent assistance, flow diversion for the fusiform wreck, Intrasaccular devices for the wide-necked residual beast, Antiplatelet protocol — but EVD needs rise at least, Parent vessel sacrifice when reconstruction fails the test, STA-MCA bypass, high-flow graft when collateral's not best, *Anastomosis* — vessel sewn to vessel, beat to beat, The surgery of patience, where precision and anatomy meet
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