A 75-year-old male presents with confusion, difficulty speaking, and right-sided weakness. His blood pressure is 220/120 mmHg. What could be the potential diagnosis, and what are the next steps?
This patient's sudden onset of confusion, speech difficulty, right-sided weakness, and significantly elevated blood pressure suggest a cerebrovascular event, such as a stroke, likely due to hypertensive emergency. Immediate management should include blood pressure control (using intravenous antihypertensives), a non-contrast CT scan of the head to differentiate between ischemic and hemorrhagic stroke, and potential thrombolytic therapy if an ischemic stroke is confirmed and the patient is within the therapeutic window.