Question

A 62-year-old arrives 2.5 hours after sudden right hemiparesis and aphasia. BP 210/110 mm Hg, NIHSS 14, CT head shows no hemorrhage. Next step for reperfusion?

Accepted Answer

Lower BP to ≤185/110 mm Hg then give IV alteplase

Answer

Give IV alteplase immediately at 0.9 mg/kg

Answer

Give aspirin 325 mg and admit to stroke unit

Answer

Start heparin infusion and plan MRI

Answer

Delay therapy until BP is <160/90 for 24 hours

Practice question

A 62-year-old arrives 2.5 hours after sudden right hemiparesis and aphasia. BP 210/110 mm Hg, NIHSS 14, CT head shows no hemorrhage. Next step for reperfusion?