Large left-sided intracerebral haematoma. It involves both deep and lobar structures (frontal and parietal lobes, basal ganglia). Its epicentre is within the left frontal white matter. There is ventricular haemorrhage but no subarachnoid haemorrhage. The haematoma is irregular but there are no finger-like projections. Within the haemorrhage are some areas of hypoattenuation (swirl sign/black hole sign).
There is significant mass effect relating to the haematoma and perihaematomal white matter oedema causing midline shift, compression of the ipsilateral lateral ventricle and third ventricle and effacement of ipsilateral cortical sulci.
Severe periventricular low attenuation probably in keeping with small vessel disease +/- transpendymal CSF spread.