Question

A 58-year-old last known well 10 hours ago has right MCA syndrome, ASPECTS 8, CTA shows proximal M1 occlusion; CTP shows small core with large penumbra. Best management?

Accepted Answer

Endovascular mechanical thrombectomy based on perfusion mismatch

Answer

Aspirin and admit; outside IV alteplase window

Answer

IV alteplase at 0.9 mg/kg

Answer

Full-dose IV heparin infusion

Answer

Delay imaging for 24 h to confirm infarct

Practice question

A 58-year-old last known well 10 hours ago has right MCA syndrome, ASPECTS 8, CTA shows proximal M1 occlusion; CTP shows small core with large penumbra. Best management?