Question

A 62-year-year-old man with acute ischemic stroke presents 2 hours after last known well. BP 178/96 mm Hg, glucose 120 mg/dL, no contraindications. Next best step?

Accepted Answer

Give IV alteplase now; BP is below 185/110 threshold

Answer

Lower BP to <=160/90 before alteplase

Answer

Withhold thrombolysis until MRI confirms infarct

Answer

Lower BP to <=140/90 before alteplase

Answer

Give aspirin 325 mg and defer thrombolysis

Practice question

A 62-year-year-old man with acute ischemic stroke presents 2 hours after last known well. BP 178/96 mm Hg, glucose 120 mg/dL, no contraindications. Next best step?