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Acute ischemic stroke — RCPSC IM MCQ

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HardNeurologyAcute ischemic strokeRCPSC IM

A 74-year-old man arrives 90 minutes after witnessed onset of aphasia and right hemiplegia. CT head shows no hemorrhage and ASPECTS is 8; CT angiography shows a left M1 occlusion. Blood pressure is 178/94 mm Hg, platelets are normal, INR is 1.0, and he has no recent surgery. What is the most appropriate management?

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Correct answer: E — Give intravenous thrombolysis and arrange immediate endovascular thrombectomy

Eligible patients with disabling ischemic stroke within the thrombolysis window should receive intravenous thrombolysis. A proximal large-vessel occlusion should also prompt rapid endovascular thrombectomy rather than delaying reperfusion.

Reference: Canadian Stroke Best Practices acute stroke management