Given this pattern of haemorrhage what underlying lesions should be considered?
An underlying vascular malformation should be sought, either an AVM or dAVF. Anterior communicating artery aneurysms can create a similar haemorrhage (so called 'flame' haemorrhage) although in this case the haemorrhage does not originate low enough for this to be a serious consideration.
Large right frontal intraparenchymal haemorrhage, approximately measuring 6 x 2.5 x 6 cm in perpendicular dimensions; with minimal surrounding vasogenic oedema and mild resultant mass effect effacing the sulci.
Extension of the haemorrhage into the ventricular system noted with blood layering within the dependent position of the lateral ventricles as well as third and forth ventricles. There is perhaps subtle prominence of the temporal horns bilaterally suggestive of an early hydrocephalus.