skip to main content

Acute ischaemic stroke with large vessel occlusion — RCPSC EM MCQ

Instant feedback + full explanation. One question, done properly.

HardNeurological emergenciesAcute ischaemic stroke with large vessel occlusionRCPSC EM

A 59-year-old man presents 70 minutes after sudden right hemiplegia and aphasia. Glucose is 6.2 mmol/L, blood pressure is 176/94 mmHg and NIHSS is 18. CT head shows no haemorrhage, while CTA shows a left M1 occlusion. The nearest comprehensive stroke centre is 45 minutes away. What is the most appropriate disposition?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Immediate transfer to a thrombectomy-capable stroke centre after initiating thrombolysis if eligible

Large vessel occlusion within the treatment window needs urgent stroke-team activation, IV thrombolysis if eligible and rapid transfer for endovascular thrombectomy. Disposition is time-critical rather than routine admission.

Reference: CAEP Acute Ischemic Stroke Position Statement; Canadian Stroke Best Practices