Case Description:

A 40-year-old woman with acute onset of severe headache, nausea, vomiting, and drowsiness is referred for evaluation and treatment of a hemorrhagic left temporal lobe mass. Unenhanced computed tomography (CT) scan of the head demonstrates increased attenuation seen anteriorly within the left temporal lobe (Fig 1). Magnetic resonance imaging (MRI) further demonstrates abnormal signal within the left temporal lobe containing areas of increased T1 and decreased T2 signal (Figs 2 and 3).

Which of the following choices is the most appropriate diagnosis?

1. dural arteriovenous malformation/fistula
2. hypertensive intracranial hematoma
3. ruptured aneurysm
4. parenchymal (pial) arteriovenous malformation
5. mass/astrocytoma with superimposed intratumoral hemorrhage