A 62-YEAR-OLD man presented with the sudden onset of headache and hemiplegia, and rapidly progressed to coma. Computed tomographic scan of the head showed a right thalamic hemorrhage with intraventricular extension (Figure 1). Routine coagulation laboratory values were normal, so the patient was treated with external ventriculostomy drainage in addition to mechanical ventilation, hypertension management, and aggressive medical resuscitation.