A 72-year-old woman with atrial fibrillation (not on anticoagulation) presents 6 hours after sudden onset of right-sided hemiparesis and aphasia. Non-contrast CT head is normal. MRI DWI shows acute infarction in the left middle cerebral artery territory. She is ineligible for IV thrombolysis due to recent hip surgery (8 days ago). What is the most appropriate next step in management?

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