Question

A 58-year-old with acute onset right-sided weakness arrives 90 minutes after last-known-well. BP 178/98 mmHg, glucose 120 mg/dL, CT head shows no hemorrhage. NIHSS 8. What is the next best step?

Accepted Answer

Administer IV alteplase 0.9 mg/kg (max 90 mg) now

Answer

Lower BP to <140/90 before thrombolysis

Answer

Wait for MRI before considering thrombolysis

Answer

Give aspirin now and observe

Answer

Delay reperfusion until cardiology evaluation

Practice question

A 58-year-old with acute onset right-sided weakness arrives 90 minutes after last-known-well. BP 178/98 mmHg, glucose 120 mg/dL, CT head shows no hemorrhage. NIHSS 8. What is the next best step?