Review Question - QID 109583

An 82-year-old man presents to the emergency department for a change in his mental status. The patient was found sitting in his chair after dinner and was difficult to arouse. He seemed to have difficulty with simple tasks and walking, so the patient's wife brought him to the emergency department. The patient has a past medical history of diabetes, hypertension, and dyslipidemia. His current medications include atorvastatin, lisinopril, insulin, and metformin. His temperature is 99.5°F (37.5°C), blood pressure is 177/99 mmHg, pulse is 90/min, respirations are 17/min, and oxygen saturation is 98% on room air. A neurologic exam is deferred due to the patient's condition. A CT scan is performed as seen in Figure A. Which of the following is the most likely cause of this patient's presentation?