Question

A 66-year-old with suspected ischemic stroke presents 2 hours after onset. BP 168/98 mm Hg, glucose 120 mg/dL, CT head shows no hemorrhage. NIHSS=8. Best next step?

Accepted Answer

Administer IV alteplase 0.9 mg/kg (max 90 mg) now

Answer

Start dual antiplatelet therapy only

Answer

Delay lysis for BP <140/90 mm Hg

Answer

Withhold therapy; observe

Answer

Give IV heparin infusion

Practice question

A 66-year-old with suspected ischemic stroke presents 2 hours after onset. BP 168/98 mm Hg, glucose 120 mg/dL, CT head shows no hemorrhage. NIHSS=8. Best next step?