A 68-year-old man presents to the emergency department with sudden onset of right-sided weakness and speech difficulty 2 hours ago. His NIH Stroke Scale score is 12. Non-contrast head CT scan is negative for hemorrhage. His blood pressure is 180/100 mmHg. Which of the following is the most appropriate next step in management?
✓ Correct Answer: Option B
For acute ischemic stroke within 4.5 hours of symptom onset with no hemorrhage on CT, intravenous thrombolysis with alteplase is indicated after blood pressure is controlled (typically <185/110 mmHg). Aspirin and clopidogrel are for secondary prevention or if thrombolysis is contraindicated.