The patient presented with a deteriorated conscious level and confusion.
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Multiple hemorrhagic lesions involving the corpus callosum and cerebral white matter bilaterally with intraventricular extension. Linear hyperdensities smearing the dural reflections and interpeduncular cistern are suggestive of subarachnoid hemorrhage.
In view of the clinical history, peripheral blood picture and bone marrow aspiration from the right iliac crest, this patient was diagnosed with acute promyelocytic leukemia. This disease can present with massive intracranial hemorrhage because of associated thrombocytopenia and treatment induced disseminated intravascular coagulopathy.