The patient had died from the effects of an intracerebral haemorrhage.
The inferior surface of the brainstem and cerebellum are displayed. There is conspicuous grooving of the cerebellar tonsils, caused by impaction of the brain into the foramen magnum. Blood is also evident over the base of the brain.
A large intra-cerebral haemorrhage is an acutely expanding intra-cranial mass, which enlarges the intra-cranial contents, causing increased intra-cranial pressure. Death frequently results from herniation of a part of the brain into or under an adjacent structure. The herniation of the cerebellar tonsils through the forament magnum is an example of this process, which is also known as "coning" of the cerebellum.