A significant amount of patients with aneurysmal subarachnoid hemorrhage suffer from cognitive impairment. The exact origin of this cognitive impairment is unclear. Lesions developing in relation to the event have been hypothesized as the mechanism of action. However, literature on this topic is inconclusive. We aimed to scrutinize this by analyzing our cohort of patients. Lesions were found in 60% of patients, no relation was found with cognitive outcome, This could be due to selection bias as most of the included patients had a good or mild impaired clinical status at admission and demonstrated ‘no cognitive impairment’ at follow-up.