Question

A 76-year-old man presents with sudden onset right-sided weakness and expressive dysphasia that started 90 minutes ago. His blood pressure is 170/96 mmHg and CT brain shows no haemorrhage. He was previously independent and takes only perindopril. What is the most appropriate immediate management?

Accepted Answer

Offer intravenous thrombolysis with alteplase after exclusion of contraindications

Answer

Start dual antiplatelet therapy with aspirin and clopidogrel without reperfusion

Answer

Commence high-dose statin therapy and admit to stroke unit without reperfusion

Answer

Lower blood pressure to below 130/80 mmHg before any reperfusion therapy

Answer

Arrange outpatient carotid ultrasound and neurology clinic review

Practice question

A 76-year-old man presents with sudden onset right-sided weakness and expressive dysphasia that started 90 minutes ago. His blood pressure is 170/96 mmHg and CT brain shows no haemorrhage. He was previously independent and takes only perindopril. What is the most appropriate immediate management?