Question

A 64-year-old man presents to the emergency department with sudden right-sided weakness and dysphasia that began 90 minutes ago. CT brain shows no haemorrhage. His blood pressure is 170/95 mmHg and blood glucose is 6.5 mmol/L. What is the most appropriate next step?

Accepted Answer

Start intravenous thrombolysis with alteplase after confirming eligibility

Answer

Withhold thrombolysis until repeat CT in 24 hours

Answer

Start aspirin 300 mg and delay reperfusion while observing for progression

Answer

Lower blood pressure immediately to 120/70 mmHg with intravenous labetalol before reperfusion

Answer

Arrange urgent carotid endarterectomy before any other intervention

Practice question

A 64-year-old man presents to the emergency department with sudden right-sided weakness and dysphasia that began 90 minutes ago. CT brain shows no haemorrhage. His blood pressure is 170/95 mmHg and blood glucose is 6.5 mmol/L. What is the most appropriate next step?