Intracerebral haemorrhage most commonly affects which regions?

• A. A haemorrhagic stroke affecting subcortical areas such as the basal ganglia, cerebellum, or brainstem.
• B. Bleeding only in the cerebral cortex.
• C. Bleeding into subarachnoid space.
• D. Bleeding into the meninges.

Answer: (A)

Intracerebral hemorrhage typically arises from rupture of small penetrating arteries affected by hypertensive arteriopathy, so the bleed tends to occur in deep, subcortical structures. The basal ganglia, especially the putamen, is the most common site, with the thalamus, cerebellum, and brainstem also frequently involved. This deep, central pattern distinguishes it from lobar cortical bleeds seen with other conditions and from bleeding into the subarachnoid space or meninges, which describe different types of hemorrhage. Therefore, bleeding in subcortical regions such as the basal ganglia, cerebellum, or brainstem best reflects intracerebral hemorrhage.