Background. Cases when unexpected death occurs, when the patient is in apparent health or the event comes during presumably normal activity, especially when it is unwitnessed or when the victim is found without apparent signs of foul play, may pose a significant chal lenge to the coroner in reaching a proper determination of the cause and the manner of death. Spontaneous intracerebral hemorrhage (ICH) is a bleeding into the parenchyma of the brain and accounts for approximately 10 % to 20 % of all strokes. ICH is a mul ti factorial disease caused by several interacting and overlapping risk factors and etiologies. When massive ICH, not connected with head trauma, has occurred, and it is multifocal or not located in one of the typical sites for hypertensive hemorrhage, one of a multitude of other causes must be suspected. High alcohol intake increases the risk of all stroke subtypes and of the development of liver diseases and may induce hypertension, by affecting brain function and producing a series of alcohol related or alcohol caused diseases and is associated with changes in the coagulation system. Liver cirrhosis is a well known risk factor for ICH, due to impaired coagulation, despite the relatively rare occurrence of ICH in cirrhotic patients. Case report. The autho rs report a case of a 48 years old man, who was admitted in the Neurosurgery Department, being found in the street, with a present state of consciousness, presenting aphasia, right hemiplegia. The first computer tomography revealed left side temporal parie tal occipital intracerebral hematoma of 52/20/45 mm, postcentral intergyral subarachnoid hemorrhage, and cerebral atrophy. On the second computer tomography, the lesions underwent moderate resorption, and a conservative treatment for ICH was chosen. After 28 days from the admission in the hospital, the patient died, due to a cardio respiratory arrest. The release diagnosis was: Left Side parietal occipital itracerebral haematoma. Right hemiparesis. Hepatic encephalopaty. Mixed decompensated alcoholic liver cirrhosis. Scleral and tegumentary jaundice. Ascites. Hypersplenism. Severe thrombocytopenia. Hypoalbuminemia. Bronchopneumonia. Schizophrenia. The body was brought for autopsy at the Iasi Forensic Institute. The necropsic examinatiation revealed: right si de occipital epicranial hemorrhagic infiltration, a left side parietal occipital lobe blood collection, cerebral oedema, pachypleuritis, bronchopneumonia, ascites (5 liters), cirrhosis, and splenomegaly. Conclusions. Proper documentation of injuries, alon g with history of the case, has a huge importance in reaching a conclusion on both the cause and the manner of death. In this case, the absence of external head injuries, the absence of underlying brain lesions that would be suggestive for a head trauma, t he presence of risk factors for primary non traumatic ICH, make a context in which the case may be properly interpreted.