The historical background of aneurysmal subarachnoid hemorrhage is depicted with emphasis in the Scandinavian contribution to improvements in the treatment. It is concluded that an aneurysmal subarachnoid hemorrhage with all certainty was the cause of death of the prospective King of Sweden, Charles August, in the year 1810. Despite advances in management and surgical treatment of this devastating disease the outcome in this important patient--which led to a new royal dynasty in Sweden--would certainly have turned out as fatal today as became the case 174 years ago.