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Catalina Sokoloff presents Milrinone for treatment of post-aneurysmal subarachnoid haemorrhage vasospasm (delayed cerebral ischaemia.) Catalina firsts explains the pathophysiology of delayed cerebral ischaemia. She makes the point that there is still much we do not know. Probable mechanisms at the microcirculation level include release of free radicals, lipid peroxidation, cortical depression spreading and microthrombi formation. The ideal treatment once delayed cerebral ischaemia is present is therefore unknown. Mechanical angioplasty seems to be favourable in some instances however has its shortcomings. As such it is often reserved as a rescue option. ‘Triple H’ therapy is intended to improve blood flow beyond constricted vessels; however, each component is flawed as Catalina explains. Intraarterial drugs have been tried however similarly, the evidence is lacking. This brings Catalina to Milrinone. This drug is a phosphodiesterase 3 inhibitor that has vasodilating and inotropic properties. Relevantly, the c