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Large vessel occlusion stroke — RCPSC EM MCQ

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HardNeurological emergenciesLarge vessel occlusion strokeRCPSC EM

CTAS 1. A 68-year-old develops aphasia and right hemiplegia 70 minutes before arrival. BP is 174/92, glucose 6.2, CT head shows no haemorrhage, and CTA shows left M1 occlusion. NIHSS is 18. The hospital has thrombolysis but no thrombectomy service. What is the most appropriate next step?

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Correct answer: A — Give thrombolysis if eligible and transfer for thrombectomy

Disabling ischemic stroke within the thrombolysis window with M1 occlusion should receive eligible IV thrombolysis and urgent endovascular pathway transfer.

Reference: Canadian Stroke Best Practices: Acute Stroke Management, 2022 with 2025 EVT update