28th May 2025

A 60-year-old is seen in A&E with sudden onset of severe left-sided weakness and mixed expressive and receptive dysphasia.

A 60-year-old is seen in A&E with sudden onset of severe left-sided weakness and mixed expressive and receptive dysphasia. His symptoms started two hours previously. His past medical history includes atrial fibrillation and asthma. He lives at home with his wife, is fully independent, and works as a teacher. He takes apixaban for atrial fibrillation and took his last dose a few hours ago, just before his symptoms started. His initial CT brain shows no bleeding but there is a dense vessel sign in the right middle cerebral artery. Initial blood tests were normal, except for an INR of 1.8 and partial thromboplastin time (PT) of 16 seconds.

Which of the following options is the correct acute management of this patient?