A 67-year-old man with a history of hypertension and atrial fibrillation presents to the emergency department with acute onset left-sided weakness and left facial drooping that began 2 hours ago. He denies headache, vision changes, or recent trauma. His wife states he was at baseline cognitively just before symptom onset. Vital signs: BP 158/92 mmHg, HR 88 (irregularly irregular), RR 16, Temperature 37.2°C, SpO2 98% on room air. On examination, he has left upper and lower extremity weakness (4/5), left facial droop, and intact speech. Point-of-care glucose is 118 mg/dL. Non-contrast CT head shows no acute intracranial hemorrhage, mass, or edema. Which of the following is the most appropriate next step in management?

1. A)Administer intravenous alteplase (recombinant tissue plasminogen activator)GABARITO
2. B)Initiate unfractionated heparin infusion and arrange urgent carotid imaging
3. C)Obtain diffusion-weighted imaging MRI to confirm acute ischemia before thrombolysis
4. D)Administer aspirin 325 mg orally and perform serial neurologic examinations
5. E)Perform emergent mechanical thrombectomy without further imaging