Review Question - QID 217227

A 65-year-old woman is brought to the emergency department for sudden-onset weakness. She was eating dinner with her family 1 hour prior to arrival when she suddenly began slurring her words and experiencing right arm weakness. She attempted to stand but fell onto her right side. She did not hit her head or lose consciousness. Her medical problems consist only of hypertension for which she takes amlodipine. She has a 45-pack-year smoking history. The patient’s temperature is 99.6°F (37.6°C), blood pressure is 145/90 mmHg, pulse is 90/min, and respirations are 20/min. Neurological examination reveals right-sided facial weakness that spares the forehead. Motor exam is notable for 2/5 strength in wrist flexion/extension, elbow flexion/extension, and knee flexion/extension on the right side. Strength is 5/5 on the left side. Fingerstick blood glucose is 106 mg/dL. A non-contrast computed tomography (CT) scan of the head is done and does not reveal any hyperdense lesions. Which of the following is the most appropriate next step in management?