We report a patient with metastatic gestational choriocarcinoma who presented with headaches, speech difficulties, motor aphasia, facial weakness, hemiparesis, and a large intraparenchymal hematoma. She subsequently developed a total of five intraparenchymal hemorrhages. Her clinical presentation posed a diagnostic dilemma and emphasizes the importance of a complete differential diagnosis of multiple intracranial hemorrhages. The features of CNS choriocarcinoma are reviewed.