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Acute ischaemic stroke eligible for reperfusion assessment — MCCQE Part 1 MCQ

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HardVisual DisturbanceAcute ischaemic stroke eligible for reperfusion assessmentMCCQE Part 1

A 72-year-old woman develops sudden right arm weakness and expressive aphasia 70 minutes before arrival. Blood glucose is normal, blood pressure is 176/94 mmHg, and she takes no anticoagulants. What is the most appropriate investigation?

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Correct answer: E — Immediate non-contrast CT head with vascular imaging per stroke protocol

Acute focal neurological deficit within a reperfusion window requires urgent stroke protocol imaging to exclude haemorrhage and assess for thrombolysis or thrombectomy pathways. Outpatient imaging would miss time-sensitive treatment. Lumbar puncture and carotid ultrasound are not the first steps in acute stroke triage.

Reference: Canadian Stroke Best Practices