This is a case of a hemorrhagic stroke in the left basal ganglia.

This area of the brain is especially at risk in hypertensive hemorrhage due to the high vascular supply and the stress placed on the vessels here.

These findings are one of the main indications for prompt CT imaging in suspected strokes as if this patient was given thrombolysis or high dose aspirin it would make the whole case worse.

Most of the management is focussed on blood pressure control, managing any further complications and stroke rehabilitation.

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Thanks to Dr Mohammad Taghi Niknejad for originally uploading this case.  The original can be viewed here.