Question

A 68-year-old presents within 90 minutes of last-known-well with disabling unilateral weakness and occlusive thrombus not yet evaluated for large vessel occlusion. BP 178/98; glucose 125 mg/dL; CT head shows no hemorrhage. Which time-sensitive therapy is indicated if no contraindications?

Accepted Answer

IV alteplase within 4.5 hours of onset after BP lowered to target

Answer

Aspirin 325 mg now and dual antiplatelet therapy within 24 h

Answer

Tenecteplase at 0.25 mg/kg beyond 9 hours

Answer

Wait for MRI/perfusion before any therapy

Answer

Heparin bolus and infusion

Practice question

A 68-year-old presents within 90 minutes of last-known-well with disabling unilateral weakness and occlusive thrombus not yet evaluated for large vessel occlusion. BP 178/98; glucose 125 mg/dL; CT head shows no hemorrhage. Which time-sensitive therapy is indicated if no contraindications?