Descriptions of superficial haemorrhages and of saccular aneurysms at the base of the brain appeared separately in the medical literature, before the first report of a ruptured basal aneurysm in 1813 (Blackall). This first patient was young, a recurrent characteristic in many later observations. Since the diagnosis was made only at autopsy, a fatal outcome seemed to be the rule, until preceding episodes of sudden, unusually severe headache were recognized (Stumpff, Wichern). A distinctive feature of ruptured aneurysms of the internal carotid artery was attendant oculomotor palsy (Stumpff); this allowed the first diagnosis during a patient’s life, in 1920 (Symonds). Less specific were neck stiffness, retinal haemorrhages (Litten), caused by rupture of swollen veins (Terson, Manschot), and, after the introduction of lumbar puncture (Quincke, 1891), the demonstration of bloodstained cerebrospinal fluid.