CT
Axial non-contrast
Sagittal non-contrast
Coronal non-contrast
Is this likely a primary haemorrhage or should an underlying lesion be sought?
A basal ganglia haemorrhage in an older patient with known poorly controlled hypertension can in many instances be assumed to be hypertensive in nature, however this case has a concerning feature: the haemorrhage reaches down to the region of the anterior communicating artery, and an aneurysm in this location can result in this pattern of haemorrhage. Also, no known hypertension.
Large haemorrhage is noted arising in the parenchyma near the caudate head on the left side, inferiorly reaching the interhemispheric fissure and superiorly entering the ventricles. Vast amounts of intraventricular haemorrhage are present with hydrocephalus.