Large left intraparenchymal hematoma centered at the level of basal ganglia extending intraventricularly, with mild rightward midline shift and signs of secondary ventricular sequestration of ventricles bilaterally.
Left-sided arteriovenous malformation is seen just lateral to the parenchymal hematoma. Arterial supply arising ipsilaterally from the MCA (M2 segment) with superficial and deep venous drainage; consistent with grade 3-4 AVM (Spetzler-Martin grading system).
The hemorrhage is possible to be directly caused by the AVM, or related to a hypertensive state in the context of damage and gliosis of the surrounding tissue thought to be triggered by a chronic vascular disruption that led to a vascular steal phenomenon.