A 68-year-old with acute right-sided weakness arrived 125 minutes after last-known-well. Blood pressure is 182/100 mm Hg, glucose 110 mg/dL, non-contr...

Question

A 68-year-old with acute right-sided weakness arrived 125 minutes after last-known-well. Blood pressure is 182/100 mm Hg, glucose 110 mg/dL, non-contrast head CT shows no haemorrhage, and he is not taking anticoagulants. What is the most appropriate next step?

Accepted Answer

Administer intravenous alteplase 0.9 mg/kg (10% bolus, remainder over 60 minutes; max 90 mg) now

Answer

Start aspirin 325 mg immediately

Answer

Begin unfractionated heparin infusion

Answer

Defer reperfusion until blood pressure is

Answer

Obtain CT angiography first and delay therapy until imaging

us-abem MCQ (SBA): Acute Ischaemic Stroke

A 68-year-old with acute right-sided weakness arrived 125 minutes after last-known-well. Blood pressure is 182/100 mm Hg, glucose 110 mg/dL, non-contrast head CT shows no haemorrhage, and he is not taking anticoagulants. What is the most appropriate next step?