Patients presenting with subarachnoid hemorrhage from aneurysmal rupture benefit from early repair of the aneurysm. Recent advances in endovascular technology now allow informed discussion of the merits of surgical versus endovascular repair of the aneurysm. Patients need close observation in an intensive-care unit following subarachnoid hemorrhage to diagnose and treat the multiple complications that result. These complications include hydrocephalus, fever, neurogenic pulmonary and cardiac dysfunction, and the development of delayed cerebral ischemia from vasospasm. There exist effective medical and endovascular treatments for cerebral vasospasm.