A 52-year-old man presents to the ED with a complaint of mild left-sided weakness that began approximately 2 hours ago while he was performing yard work. Patient History: The patient has a history of COPD and still smokes 1 pack of cigarettes per day. Physical Examination: While in the emergency department, he complains of a severe headache associated with emesis. His BP is 190/100 mm Hg; the pulse is 76 beats/minute and regular. Neurologic examination shows no papilledema, dysarthria, or facial drooping.
The patient then receives intravenous recombinant tissue plasminogen activator (rTPA) therapy and shortly thereafter develops acute weakness of the left arm and leg along with slurred speech. An emergent repeat CT scan is performed (Images attached). What is the most likely diagnosis and what is the next step in the treatment of this patient? *This patient case is from Docplexus…
