Medical Scenario

Your patient is a 49 y/o female who presents with acute onset of dysphasia and left side weakness.  You also note left arm drift.  You (obviously) suspect stroke.  After questioning the patient and family you determine that the symptoms began almost 5 hours earlier.  You attach the pulse oximeter, start an IV, check glucose, and attach the ECG monitor.  You then move the patient to the ambulance and prepare for transport.  The nearest hospital is 10 miles away.  The nearest stroke center is 35 miles away.  The nearest comprehensive stroke center (capable of administering intraarterial fibrinolytics and clot retrieval) is 54 miles away.  Which hospital is your better choice in this case?  Why?