Cerebral vascular disease Quiz: Ace Your Exams

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A 74-year-old woman is brought to the emergency department for evaluation of weakness and sensation disturbance in the left upper and left lower extremity for three hours. The patient was gardening, when she noticed she could no longer firmly grasp her trowel with her left hand. The patient became more concerned when she developed a diffuse headache shortly thereafter. Her daughter called emergency medical services after the patient became somnolent. The patient has a history of uncontrolled hypertension. Current temperature is 37°C (98.6°F), pulse is 81/min and regular, and blood pressure is 201/104 mmHg. On initial evaluation, the patient is difficult to rouse. Physical examination demonstrates 2/5 weakness in her left upper and left lower extremity. There is decreased sensation to light touch and pinprick on the left side. A non-contrast CT of the head is shown below:

A CT scan shows a brain w/ a large, bright white mass in the center, indicating a hemorrhage. Darker areas are visible around the mass & on the sides of the brain, suggesting edema or older infarcts.
Reproduced from: Radiopaedia  

Which of the following best describes the underlying pathophysiology of this patient’s clinical condition?  

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