Brief Answer:
Large stroke, needs ICU care

Detailed Answer:
Hi XXXXXXX I have gone through your question and understand your concerns.
I have reviewed the reports.
The MRI and MRA are suggestive of a large stroke due to right carotid artery involvement or blockage. It is a major stroke with guarded prognosis.
Left carotid artery is also showing narrowing, which is not a good sign.
I will suggest you to admit him in a tertiary care hospital with ICU facilities.
Blood pressure should me controlled by proper medications.
Drugs for decreasing intracranial pressure like mannitol,3% Saline, Lasix should be given accordingly.
Postural care and physiotherapy should be done regularly.
Ecospirin should be started to prevent further blockage of other major vessels.
A good ICU care is must in this case.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards
Dr Neeraj Kumar
Neurologist

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