Sudden loss of consciousness.
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A large cerebellar hemorrhage is present in the vermis and left hemisphere extending into the 4th ventricle. Blood has refluxed into the third ventricle and is seen in the occipital horns of the lateral ventricles with obstructive hydrocephalus.
The hematoma is exerting marked mass effect compressing the pons.
An old infarct involves the right parietal region.
This case illustrates typical appearances of a large cerebellar hematoma usually seen in the setting of poorly controlled hypertension. They were already impaired from the previous stroke and were being cared for in a nursing home. It was elected, in accordance to the patient's and wishes and those of his family to not treat this event. This patient passed away shortly after the scan was obtained.