MRCP2-3157

MRCP2-3157

A 44-year-old woman presents to the emergency department with symptoms of dysphasia, visual disturbance, and weakness that have been ongoing for two hours. Upon examination, she is found to have left homonymous hemianopia, left-sided hemiparesis with sensory loss, and dysphasia. Her vital signs are stable, with a heart rate of 102/min and blood pressure of 145/82 mmHg.

An urgent CT head and angiography are scheduled, which reveal a large infarct in the territory of the middle cerebral artery in the right cerebrum, with proximal occlusion seen on the CT angiography.

The patient has no significant medical history, and her blood work is normal. Her modified Rankin score is 1, and her national institutes of health stroke scale (NIHSS) is 12.

Given that four hours have passed since presentation, what is the next most appropriate course of action in her management?