18th August 2024

A 65-year-old man is assessed for new neurological symptoms. He is seen with his wife

A 65-year-old man is assessed for new neurological symptoms. He is seen with his wife who reports that whilst talking to her he developed sudden-onset facial drooping and was suddenly unable to speak, making sounds which she could not understand. He was unable to stand up, instead falling over, and seemed to be weak on his right hand side. He has a background of atrial fibrillation and hypertension for which he is on rivaroxaban and amlodipine. His wife reports he takes his tablets every morning. The onset of his symptoms was approximately one hour and 30 minutes ago at midday. On examination, he has a right hemiparesis, dysphasia and dysarthria. His blood pressure is 150/70, heart rate is 80 and irregular and his blood sugar is 7.6.  He has a CT head which excludes haemorrhage, and there is no large vessel occlusion on CTA. What is the next most appropriate intervention?

Select the SINGLE most appropriate option from the list below. Select ONE option only.