Question

A 68-year-old presents within 90 minutes of acute right hemiparesis (NIHSS 9). BP 200/110 mmHg, glucose 110 mg/dL, CT head shows no bleed. What is the best next step to enable IV alteplase?

Accepted Answer

Proceed with alteplase without BP control

Answer

Administer aspirin then alteplase

Answer

Start IV labetalol to reduce BP <185/110 mmHg, then give alteplase

Answer

Wait 6 hours for spontaneous improvement

Answer

Immediate heparin infusion

Practice question

A 68-year-old presents within 90 minutes of acute right hemiparesis (NIHSS 9). BP 200/110 mmHg, glucose 110 mg/dL, CT head shows no bleed. What is the best next step to enable IV alteplase?