04-29-2009, 08:21 AM
A 61-year-old man is evaluated in the emergency department for mild left-sided weakness and left visual field loss that began about 6 hours ago. He has a history of diet-controlled hypertension. His current blood pressure is 160/75 mm Hg, and heart rate is 110/min and irregular.
Physical examination reveals an irregularly irregular cardiac rhythm but is otherwise normal. Neurologic examination reveals a partial left homonymous hemianopsia, a left central facial palsy, mild left upper-extremity weakness, and mild left sensory loss. Complete blood count and serum electrolytes and glucose are normal. Electrocardiography reveals atrial fibrillation. CT scan of the brain shows early hypodensity of the right basal ganglia and insula.
Which of the following is the most appropriate therapy?
A Warfarin
B Enoxaparin
C Clopidogrel
D Adenosine
Physical examination reveals an irregularly irregular cardiac rhythm but is otherwise normal. Neurologic examination reveals a partial left homonymous hemianopsia, a left central facial palsy, mild left upper-extremity weakness, and mild left sensory loss. Complete blood count and serum electrolytes and glucose are normal. Electrocardiography reveals atrial fibrillation. CT scan of the brain shows early hypodensity of the right basal ganglia and insula.
Which of the following is the most appropriate therapy?
A Warfarin
B Enoxaparin
C Clopidogrel
D Adenosine