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Images in…This case adds to the current literature on ICH as a rare initial manifestation of T-ALL in paediatric patients. It demonstrates the neuroimaging characteristics of acute leukaemias presenting with ICH and reveals the role of managing hyperleucocytosis, platelet and coagulation abnormalities in the face of ICH for improved clinical outcomes.Contributors CH was responsible for the design and writing of the case report. YYL was responsible for the design and writing of the case report. JRC was responsible for the design and writing of the case report.

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