A 69-year-old woman arrives as triage level 1 with aphasia and right hemiplegia that began 70 minutes ago. BP is 182/96 mm Hg, glucose is 112 mg/dL,

Question

A 69-year-old woman arrives as triage level 1 with aphasia and right hemiplegia that began 70 minutes ago. BP is 182/96 mm Hg, glucose is 112 mg/dL, noncontrast head CT shows no hemorrhage, and CTA shows left M1 occlusion. Which of the following is the most appropriate next step in management?

Accepted Answer

Give IV thrombolysis if eligible and activate endovascular thrombectomy pathway

Answer

Lower BP to less than 120/80 before any reperfusion therapy

Answer

Start heparin infusion as definitive therapy

Answer

Delay treatment until MRI confirms infarct core

Answer

Give aspirin and discharge if speech improves

Large-vessel ischemic stroke — ABEM Board MCQ

A 69-year-old woman arrives as triage level 1 with aphasia and right hemiplegia that began 70 minutes ago. BP is 182/96 mm Hg, glucose is 112 mg/dL, noncontrast head CT shows no hemorrhage, and CTA shows left M1 occlusion. Which of the following is the most appropriate next step in management?