A 63-year-old with suspected stroke presents at 5 hours from last known well. CT negative for hemorrhage; perfusion shows small core with large penumb...

Question

A 63-year-old with suspected stroke presents at 5 hours from last known well. CT negative for hemorrhage; perfusion shows small core with large penumbra; LVO absent. Best management?

Accepted Answer

No thrombolysis; treat medically and consider enrollment in trials

Answer

IV alteplase because extended window to 6 hours for all

Answer

Immediate mechanical thrombectomy

Answer

Heparin infusion

Answer

Tenecteplase 0.4 mg/kg routine

us-abem MCQ (SBA): AIS Beyond tPA Window without LVO

A 63-year-old with suspected stroke presents at 5 hours from last known well. CT negative for hemorrhage; perfusion shows small core with large penumbra; LVO absent. Best management?