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Large vessel ischaemic stroke — ACEM Fellowship MCQ

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HardNeurological emergenciesLarge vessel ischaemic strokeACEM Fellowship

A 67-year-old man presents to a Melbourne stroke-capable ED, triage category 1, 70 minutes after aphasia and right hemiplegia. BP 168/92, glucose 6.2 mmol/L. CT excludes haemorrhage and CT angiography shows left M1 occlusion. NIHSS is 18. What is the most appropriate investigation?

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Correct answer: B — Non-contrast CT brain with CT angiography

Suspected acute stroke needs non-contrast CT to exclude haemorrhage plus CTA to identify thrombectomy-amenable occlusion.

Reference: Australian stroke guideline; ACEM neurology curriculum