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Acute Ischaemic Stroke — UKMLA MCQ

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EasyNeurologyAcute Ischaemic StrokeUKMLA

A 70-year-old man presents with sudden onset of right-sided weakness and speech difficulty that started 1 hour ago. Non-contrast CT head shows no haemorrhage. Which intervention should be offered urgently?

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Correct answer: B — IV thrombolysis with alteplase

In acute ischaemic stroke presenting within the treatment window (usually within 4.5 hours) and no contraindications, IV alteplase is recommended. Aspirin is started 24 hours post-thrombolysis if there's no haemorrhage. Mechanical thrombectomy is for large vessel occlusions in selected patients, often with or after IV thrombolysis. LMWH is not standard immediate therapy in acute stroke.

Reference: NICE Stroke Guideline