The correlation between angiographic vasospasm, hematoma, and ischemic brain damage was studied in 29 patients who died as a result of subarachnoid hemorrhage following rupture of a saccular aneurysm. None of these patients was treated surgically. A comprehensive neuropathological examination was undertaken in each case. A significant relationship between the presence and degree of vasospasm and ischemic brain damage was found. Furthermore, even though intracerebral hematoma probably increased the risk of infarction associated with vasospasm, hematoma per se did not increase the incidence of ischemic brain damage.