Question

A 66-year-old with acute ischemic stroke has last-known-well 2 hours ago, BP 168/92 mmHg, NIHSS 8, noncontrast CT shows no hemorrhage. What is the best next step?

Accepted Answer

Delay reperfusion and obtain MRI first

Answer

Permissive hypertension for 24 hours, then start aspirin

Answer

Endovascular thrombectomy because within 6 hours

Answer

IV alteplase (tPA) now after BP control to <185/110 mmHg

Answer

Full-dose heparin infusion

Practice question

A 66-year-old with acute ischemic stroke has last-known-well 2 hours ago, BP 168/92 mmHg, NIHSS 8, noncontrast CT shows no hemorrhage. What is the best next step?