On arrival, this patient is not alert but arousable to voice, looking to the right with left-sided neglect, pupils reactive 4 mm to 3 mm OU, left upper extremity 2/5 motor response to painful stimulus, left lower extremity 3/5 motor response to same. There is no sensation to the left upper extremity. He has no evidence of trauma, no murmur, and is in normal sinus rhythm on the monitor.
CT non-contrast is performed immediately:
Regarding his presentation and management, which is the BEST answer:
A. Obtain emergent neurosurgery consultation for possible coil embolization
B. Initiate titratable anti-hypertensive agent to target systolic blood pressure
of 140 mmHg
C. Give alteplase 0.9 mg/kg actual body weight o a maximum of 90 mg/kg
D. Give aspirin 325 mg PO
In the meantime, a quote --
"You medical people will have more lives to answer for in the other world than even we generals."
-- Napoleon Bonaparte