A 71-year-old man with atrial fibrillation on Warfarin presents with sudden right-sided weakness and dysphasia that started 90 minutes ago. CT head ex...

Question

A 71-year-old man with atrial fibrillation on Warfarin presents with sudden right-sided weakness and dysphasia that started 90 minutes ago. CT head excludes haemorrhage. He has no contraindications to thrombolysis. What is the most appropriate immediate management?

Accepted Answer

Give intravenous Alteplase thrombolysis according to protocol.

Answer

Increase his Warfarin dose to achieve higher INR.

Answer

Start Aspirin 300 mg immediately and withhold thrombolysis.

Answer

Arrange MRI brain and review in 24 hours.

Answer

Start Aspirin and Clopidogrel dual therapy instead of thrombolysis.

uk-plab-1 MCQ (SBA): Acute ischaemic stroke – thrombolysis

A 71-year-old man with atrial fibrillation on Warfarin presents with sudden right-sided weakness and dysphasia that started 90 minutes ago. CT head excludes haemorrhage. He has no contraindications to thrombolysis. What is the most appropriate immediate management?