68-year-old man is brought to the emergency department for acute right-sided hemiplegia, headache, and impaired consciousness.
His symptoms started an hour ago and are progressively getting worse. He has no prior history of transient ischemic attack. His
medical problems include obesity, gout, benign prostatic hyperplasia, benign essential tremor, hypertension, and
hypercholesterolemia The patient’s medications include allopurinol, tamsulosin, propranolol, amlodipine, and simvastatin. He has
smoked a pack of cigarettes daily for 15 years Neurological examination shows right-sided weakness and hemi-sensory loss. There
is a carotid bruit on his left side. Which of the following is the most appropriate next step in management?
- QA Anticoagulation with heparin
- 0 B. Carotid Doppler
- 0 C. CT angiography of the head and neck
- 0 D. CT of the head without contrast
- 0 E. Echocardiogram
- 0 F MRI of the brain
- 0 G. Treatment with aspirin