A 58-year-old develops sudden aphasia and right facial droop 2 hours ago. CT head shows no hemorrhage. BP is 200/110 mm Hg, glucose 120 mg/dL, platele...

Question

A 58-year-old develops sudden aphasia and right facial droop 2 hours ago. CT head shows no hemorrhage. BP is 200/110 mm Hg, glucose 120 mg/dL, platelets 220k, INR 1.0. What is the best next step?

Accepted Answer

Lower BP and administer alteplase 0.9 mg/kg IV (maximum 90 mg) within the 4.5-hour window

Answer

Give aspirin 325 mg now

Answer

Allow permissive hypertension and avoid thrombolysis

Answer

Administer tenecteplase 0.5 mg/kg IV

Answer

Proceed directly to mechanical thrombectomy alone

us-abem MCQ (SBA): Acute Ischemic Stroke

A 58-year-old develops sudden aphasia and right facial droop 2 hours ago. CT head shows no hemorrhage. BP is 200/110 mm Hg, glucose 120 mg/dL, platelets 220k, INR 1.0. What is the best next step?