Question

A 76-year-old man presents with sudden right-sided weakness and aphasia that began 90 minutes ago. CT head shows no haemorrhage. CT angiography shows an occlusion of the left middle cerebral artery. Blood pressure is 170/95 mm Hg and glucose is 7.0 mmol/L. What is the most appropriate immediate management?

Accepted Answer

Administer intravenous thrombolysis with alteplase and consider mechanical thrombectomy

Answer

Begin aspirin only and arrange physiotherapy

Answer

Defer treatment until MRI confirms infarct size

Answer

Lower blood pressure rapidly to below 120/80 mm Hg before any other therapy

Answer

Discharge home because symptoms are likely to resolve spontaneously

Practice question