A 70-year-old male presents to the ED with sudden onset right-sided weakness and aphasia. Symptoms started 2 hours ago. His NIHSS score is 12. His blood pressure is 155/90 mmHg, and his blood glucose is 110 mg/dL. Non-contrast CT head shows no hemorrhage. He has no history of recent surgery or bleeding disorders. Which of the following is the most appropriate immediate management for this patient?
✓ Correct Answer: Option A
This patient has an acute ischemic stroke within the therapeutic window for tPA (4.5 hours from symptom onset), without hemorrhage on CT, and no contraindications. Intravenous alteplase is the standard of care to re-establish blood flow.