A 67-year-old man is brought to the ER after a sudden fall. He has slurred speech, right-sided weakness, and facial droop. BP: 180/100 mmHg. CT shows no hemorrhage.
Question:
What is the most appropriate next step in management?
A. Start aspirin immediately
B. Administer IV mannitol
C. Begin thrombolysis with tPA
D. Order MRI brain with contrast
Since it is an emergent situation Option C should be the ideal answer. 
Since there’s no bleeding on the scan, the best move is to give tPA right away—it can help dissolve the clot and restore brain function.
option B( mannitol can be administered) in case of cerebral edema. but according to case, as CT shows absence of hemorrhage, and symptoms exhibit for acute ischemic stroke (slurred speech, facial droop). the appropriate next step could be, begin thrombolysis with tPA. so the correct option is C