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According to the recent information, delayed cerebral ischemia (DCI) after aneurismal subarachnoid hemorrhage (aSAH) is likely to have a multifactorial etiology beyond pure vasospasm and the formation of microthrombosis considered to be one of the leading factors. It has been proved that aSAH is associated with the development of hypercoagulation. So, it can be assumed that pharmacological correction of the hypercoagulable state can reduce the risk of DCI. We present a clinical case where hypercoagulation was detected by thromboelastometry, since standard coagulation tests are not sensitive to such changes. It can be assumed that an integral evaluation of hemostasis (thromboelastometry), which is sensitive to the slightest shifts, as well as the adequate prophylaxis of hypercoagulation after SAH, might prevent DCI and improve the neurological outcome.