A 65-year-old man comes to the emergency department due to sud | Uworld | Step 1

A 65-year-old man comes to the emergency department due to sudden-onset headache. The patient has had no recent falls or head trauma. Medical history includes hypertension and lung adenocarcinoma with abdominal metastasis. Initial noncontrast CT scan of the head reveals a small temporal lobe hemorrhage.
Over the next 24 hours, the patient becomes progressively obtunded and develops generalized tonic-clonic seizures. Blood pressure is 190/96 mm Hg, pulse is 38/min, and respirations are 1 O/min with brief episodes of apnea. A repeat noncontrast CT scan of the head reveals acute hemorrhage expansion with brain herniation.