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Large right lobar haemorrhage which is centred in the occipital lobe, but also involves the temporal and parietal lobes. It involves cortex, subcortical white matter and periventricular white matter. There is subarachnoid but no intraventricular or subdural haemorrhage. The haematoma has multiple finger-like projections (see stack key images).
Significant mass effect from the haematoma and perihaematomal oedema resulting in midline shift, obstructive hydrocephalus of the lateral ventricles and partial effacement of the ipsilateral cortical sulci.
Mild periventricular low attenuation may represent small vessel change or transependymal CSF spread. Mild atrophy.