18th August 2024

You see a 72-year-old woman in A&E with neurological disturbance. She woke up in the night

You see a 72-year-old woman in A&E with neurological disturbance. She woke up in the night to go to the toilet but collapsed, waking up her husband who brought her to hospital. She had been well when she went to bed at 23:00. She has a background of hypercholesterolaemia and hypertension but is independent for her activities of daily living (ADLs). She is alert but there is a dense weakness of her left hand side and she is unable to tell when you are touching her left arm and leg. She is able to speak but her words are slurred and she also does not seem to notice you when you stand on her left hand side. Her blood pressure is 140/80. She has a CT head and CTA which demonstrates no haemorrhage and a hyperdensity in the right M1 branch. It is 03:00 when you assess her and you work in a hospital that offers a 24 hour thrombectomy service. What should be the next step in the patient’s management?

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