Large right acute subdual haematoma, right gyrus rectus intraparenchymal haematoma, right to left subfalcine herniation. Note the gyrus rectus haematoma extends anteriorly from the region of the anterior communicating artery. CTA performed confirms the expected ACOM aneurysm. Due to clinical state, patient immediately transferred to the operating room for neurosurgical clipping of the aneurysm and drainage of the SDH, without preceding catheter angiography.