Hemorrhagic lesions in putamen – differential includes hypertensive hemorrhage, vascular malformation, and neoplasm.

Hypertension is the presumed cause in 70-90% of cases.

Lacunar infarcts more common than hypertensive hemorrhages (15-20% vs 10-15% of strokes).

2/3 hypertensive hemorrhages occur in the putamen, usually with BP > 170.

Lobar hemorrhagic stroke more concerning for vascular malformation, amyloid angiopathy, and neoplasms.

Other causes of intraparenchymal hemorrhages include amyloid angiopathy (often multiple and not in basal ganglia), aneurysms, trauma, vasculitis, drugs, congenital and acquired coagulopathies.