Question

A 64-year-old man with sudden onset right-sided weakness and aphasia presents to the emergency department 90 minutes after symptom onset. Blood pressure is 170/100 mmHg, glucose 7.0 mmol/L. Non-contrast CT head shows no haemorrhage. What is the most appropriate next step in management?

Accepted Answer

Administer intravenous thrombolysis with tissue plasminogen activator after confirming eligibility.

Answer

Start dual antiplatelet therapy without thrombolysis.

Answer

Delay all treatment until MRI is obtained.

Answer

Begin immediate full-dose anticoagulation with heparin.

Answer

Discharge home with outpatient follow-up because symptoms may resolve spontaneously.

Practice question

A 64-year-old man with sudden onset right-sided weakness and aphasia presents to the emergency department 90 minutes after symptom onset. Blood pressure is 170/100 mmHg, glucose 7.0 mmol/L. Non-contrast CT head shows no haemorrhage. What is the most appropriate next step in management?