Medisage Academy Quiz

A 68 years old woman with atrial fibrillation comes to an emergency department because sudden onset of right body weakness and slurred speech since over 2 hrs. She has been generally very healthy besides her heart problem and takes multivitamins and warfarin. On examination, No dysesthesia and no headaches, her blood pressure is 190/95 mm Hg and her pulse is irregularly irregular. Further examination shows left sided neglect with slurred speech and weakness of the right body, face and upper extremity worse than lower extremity. Routine chemistries and cell counts are normal. Her INR is 7.7.