Hypertensive intracerebral haemorrhage

The majority of hypertensive intracerebral haemorrhages are centred in the basal ganglia, as in this dramatic example. In addition to the huge high density haemorrhage in left cerebral hemisphere, there is extension of the haemorrhage into the ventricular system (red arrows) and the subarachnoid space (orange arrows). Note the severe midline shift to the right side. Occasionally, hypertensive haemorrhages occur in the brainstem or cerebellum.

The incidence of this form of intracranial haemorrhage has been decreasing with the improved control of hypertension although they still make up around 10-15% of strokes and, not surprisingly when you look at this example, are more likely to lead to death or long term disability than non-haemorrhage stroke.