Question

A 70-year-old presents 2.5 hours after acute left hemiparesis. BP is 210/110 mmHg, glucose 110 mg/dL, CT head shows no hemorrhage. What is the best next step?

Accepted Answer

Lower BP to <185/110 mmHg with IV labetalol, then give IV alteplase

Answer

Give IV alteplase immediately at 0.9 mg/kg

Answer

Delay therapy and repeat CT in 6 hours

Answer

Start aspirin 325 mg now

Answer

Transfer for elective thrombectomy only

Practice question

A 70-year-old presents 2.5 hours after acute left hemiparesis. BP is 210/110 mmHg, glucose 110 mg/dL, CT head shows no hemorrhage. What is the best next step?