A 72-year-old man presents within 1 hour of onset of right-sided weakness and aphasia. CT brain shows no haemorrhage. CT angiography shows an occlusio...

Question

A 72-year-old man presents within 1 hour of onset of right-sided weakness and aphasia. CT brain shows no haemorrhage. CT angiography shows an occlusion of the left middle cerebral artery. He has no contraindications to thrombolysis. What is the most appropriate immediate management?

Accepted Answer

IV thrombolysis with alteplase within the therapeutic window and consideration of endovascular thrombectomy

Answer

Aspirin alone

Answer

Start anticoagulation with heparin infusion

Answer

Delay treatment and repeat CT in 24 hours

Answer

High-dose steroids

au-amc MCQ (SBA): Acute ischaemic stroke thrombolysis

A 72-year-old man presents within 1 hour of onset of right-sided weakness and aphasia. CT brain shows no haemorrhage. CT angiography shows an occlusion of the left middle cerebral artery. He has no contraindications to thrombolysis. What is the most appropriate immediate management?