PF4 and intracerebral hemorrhage: Here, we report the complicated long-term course of a VITT patient with extremely high titers of pathogenic anti-platelet factor 4 (PF4)-IgG antibodies.<h4>Methods</h4>Clinical and laboratory findings are presented, including the course of platelet counts, D-Dimer levels, clinical presentation, imaging, SARS-CoV-2-serological and immunological, platelet activating anti-PF4-IgG, as well as autopsy findings.<h4>Results</h4>The patient presented with extended superior sagittal sinus thrombosis with accompanying bifrontal intracerebral hemorrhage.