MRCP2-3195

MRCP2-3195

An 77-year-old man was brought to the emergency department by his wife due to concerns about his speech and left-sided weakness. These symptoms had been present since breakfast that morning and had persisted throughout the day. The patient has a history of hypertension and takes amlodipine, but is otherwise independent in his daily activities and does not smoke.

Upon examination, the patient was found to have dysarthria and hemisensory loss on his left side, with 2/5 power in his left leg and arm. His pulse was irregular, but his vital signs were stable. A CT angiogram with perfusion imaging revealed a thrombus in the right middle cerebral artery, with a small area of infarct and a large area of surrounding ischaemic penumbra.

What is the most appropriate course of action for managing this patient?