Question

A 63 year old man presents with acute onset right sided weakness and slurred speech that began 45 minutes ago. CT scan of the head without contrast shows no haemorrhage. Blood pressure is 178 over 96 mm Hg, blood glucose is 110 mg per dL, and there are no contraindications to thrombolysis. According to current stroke guidelines, what is the most appropriate next step?

Accepted Answer

Administer intravenous alteplase at 0.9 mg per kg with 10 percent as a bolus and the remainder over 60 minutes

Answer

Start aspirin 325 mg only and admit to stroke unit

Answer

Delay thrombolysis until MRI confirms ischaemic stroke

Answer

Lower blood pressure to less than 140 over 90 mm Hg before any therapy

Answer

Administer full dose low molecular weight heparin for anticoagulation

Practice question