18th August 2024

The nurses call you to review a 62-year-old gentleman on the stroke unit. He presented overnight with dysarthria

The nurses call you to review a 62-year-old gentleman on the stroke unit. He presented overnight with dysarthria, left arm and leg weakness and left-sided neglect. His CT on arrival excluded haemorrhage and he received thrombolysis. His NIHSS had improved from 10 to 6 one hour following administration of alteplase. You review the gentleman on the ward. He is currently 8 hours post-thrombolysis. He is drowsy and NIHSS score has increased to 12. His temperature is 36.7, his blood pressure is 165/90 mmHg and his heart rate is 60 bpm. His blood sugar level is 5.6. What is the next most appropriate intervention?

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