A 62-year-old female with a history of diabetes and hypertension presents with sudden onset of weakness in the right side of her body and difficulty speaking, which started about an hour ago. Physical examination confirms right-sided weakness and expressive aphasia. What is the likely diagnosis, and what are the next steps?
The patient's symptoms suggest an acute ischemic stroke, which is often due to atherosclerosis. Given the time frame, she is within the window for acute intervention, including thrombolysis with tissue plasminogen activator (tPA). The next step should be immediate neuroimaging with a non-contrast head CT to rule out hemorrhagic stroke. If there is no evidence of hemorrhage, and no other contraindications exist, she should receive tPA.