Medicine

Last updated on: October 28th, 2024

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Cerebrovascular Diseases 3

A 72-year-old man is brought to the emergency department after complaining of sudden onset of left-sided weakness and slurred speech 4 hours ago. He has a past medical history of poorly controlled hypertension and type 2 diabetes mellitus. His temperature is 37.3ºC (99.1ºF), pulse is 82/min, respiration is 16/min, and blood pressure is 180/102 mmHg. His O2 saturation is 98% on room air. He is awake and alert. He has a left central facial palsy, a left-sided hemiparesis grade 2/5, with a left-sided Babisnki sign. His NIH Stroke Scale score is 11 (000122202001010). His blood glucose is 180 mg/dL. ECG shows normal sinus rhythm. A CT scan shows a large right-hemispheric infarction without evidence of edema (ASPECTS 4). A hyperdense sign is visible in the middle cerebral artery. The patient is admitted to the hospital's stroke unit. Which of the following is the most appropriate next step in his management?

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