A 68-year-old man is brought to the emergency department for a | Surgery collections Videos and quizez 2021

A 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.