MRCP2-2333

MRCP2-2333

A 36-year-old patient with a history of sickle cell disease presents to the emergency department with sudden onset of left arm and facial weakness. The symptoms started earlier in the day. The patient is usually very cautious with his sickle disease and ensures he stays hydrated and avoids cold temperatures. However, his wife reports that he has been experiencing nausea, vomiting, and diarrhea for the past few days after eating a takeaway meal three days ago. Upon examination, the patient’s vital signs are normal. He has slurred speech and a noticeable left facial droop with forehead sparing. He has no other neurological deficits except for a left arm power of 0/5.

The patient’s blood tests reveal:

– Hemoglobin: 100 g/L
– Platelets: 330 * 10^9/L
– White blood cells: 8.9 * 10^9/L
– INR: 1.0
– Sodium: 138 mmol/L
– Potassium: 3.5 mmol/L
– Urea: 9.9 mmol/L
– Creatinine: 135 µmol/L
– CRP: 19 mg/L (<10)
– Bilirubin: 12 µmol/L
– ALP: 89 U/L
– ALT: 39 U/L
– Albumin: 39 g/L

The stroke team evaluates the patient and orders an urgent CT head, which comes back normal. What is the appropriate treatment for this patient?