Findings:
Re-demonstrated right basal ganglia hemorrhage without intercurrent hemorrhage. There are persistent blood products within the right lateral ventricle, foramen of Monro, third ventricle, and layering within the occipital polar regions bilaterally. There is extension of blood clot within the cerebral aqueduct into the fourth ventricle. There is a slight increase of the ventricular dilatation since the last study.

Following IV contrast administration, there is no abnormal area of parenchymal enhancement of active contrast extravasation. There is no definitive aneurysm at the circle of Willis. There is prominence of a lateral lenticulostriate/posterior frontal developmental variant without evidence of an underlying vascular shunt lesion. This vessel is also localized laterally relative to the area of hemorrhage.

Impression:
Persistent predominantly right basal ganglia focus of hemorrhage with intraventricular extension consistent with hypertensive etiology. There is no intercurrent hemorrhage or vascular etiology in this limited exam.

Recommendations:
For your training purposes, recommendations are not included in this report.