Question

A 70-year-old woman presents with sudden onset right-sided weakness and aphasia 90 minutes ago. CT head shows no haemorrhage. Blood pressure is 170/95 mm Hg, glucose 7.8 mmol/L, and there are no contraindications to thrombolysis. Which is the most appropriate acute management?

Accepted Answer

Administer IV Alteplase at stroke-appropriate dose

Answer

Start Aspirin 325 mg and delay thrombolysis for 24 hours

Answer

Begin therapeutic low-molecular-weight heparin

Answer

Withhold treatment and repeat CT in 24 hours

Answer

Lower blood pressure to 110/70 mm Hg before any therapy

Practice question

A 70-year-old woman presents with sudden onset right-sided weakness and aphasia 90 minutes ago. CT head shows no haemorrhage. Blood pressure is 170/95 mm Hg, glucose 7.8 mmol/L, and there are no contraindications to thrombolysis. Which is the most appropriate acute management?