Intracranial haemorrhage (ICH), a rare complication of idiopathic thrombocytopenic purpura (ITP), described only once previously in an adult, is usually fatal. We report a previously healthy 26 year old woman with chronic ITP in whom spontaneous ICH developed. The eventual favourable outcome in this case despite severe initial neurological deficit makes this case unusual. The importance of aggressive management in an ITP associated ICH is stressed and a plan for management is suggested.