Hypertensive bleed is common in elderly population who have missed their treatment for hypertension or are consuming blood thinner drugs. They can be at any part of the brain and if large in size, require immediate evacuation. These patients require a long postoperative ICU care and rehabilitation. In young patients with intracranial hematoma, usually there is an underlying vascular malformation which can be diagnosed by a cerebral angiogram. Representative pictures are attached.