Question

A 59-year-old man with sudden dysarthria and right arm weakness (NIHSS 8) presents 90 minutes after onset. BP 176/98 mm Hg, glucose 110 mg/dL, CT head: no hemorrhage. What is the best immediate therapy?

Accepted Answer

Administer IV alteplase (tPA) after BP <=185/110 mm Hg

Answer

Start aspirin 325 mg now and defer thrombolysis

Answer

Proceed to mechanical thrombectomy without thrombolysis

Answer

Lower BP to <=160/90 mm Hg and observe

Answer

Give heparin infusion

Practice question

A 59-year-old man with sudden dysarthria and right arm weakness (NIHSS 8) presents 90 minutes after onset. BP 176/98 mm Hg, glucose 110 mg/dL, CT head: no hemorrhage. What is the best immediate therapy?