An uncommon case of sudden intraventricular bleeding following right thalamic hemorrhage is described in a very old female with chronic arterial hypertension. Computed tomography disclosed images of right thalamic hematoma with midline shift, and bilateral bleeding in both posterior horns of the lateral ventricles. Intraventricular extension occurred early in the course of the intracranial hemorrhage and could have carried ominous outcome, because of higher morbidity and mortality rates. Despite of diverse complications, conservative management of the old-aged patient was successful.