Question

A 65-year-old man is brought to the ED with sudden onset right-sided weakness and aphasia that began 45 minutes ago. Blood pressure is 178/96 mm Hg, glucose 108 mg/dL, and non-contrast CT head shows no hemorrhage. NIH Stroke Scale is 14. What is the most appropriate next step?

Accepted Answer

Administer IV alteplase at 0.9 mg/kg

Answer

Start aspirin 325 mg and admit for observation

Answer

Delay thrombolysis until MRI confirms infarction

Answer

Start IV heparin infusion

Answer

Lower BP immediately to <120/80 mm Hg before thrombolysis

Practice question

A 65-year-old man is brought to the ED with sudden onset right-sided weakness and aphasia that began 45 minutes ago. Blood pressure is 178/96 mm Hg, glucose 108 mg/dL, and non-contrast CT head shows no hemorrhage. NIH Stroke Scale is 14. What is the most appropriate next step?