Question

A 64-year-old woman with sudden onset right-sided weakness and aphasia presents to a rural emergency department 1.5 hours after symptom onset. CT brain shows no haemorrhage. NIH Stroke Scale score is 12. There is no contraindication to thrombolysis. What is the most important next step?

Accepted Answer

Administer intravenous thrombolysis and arrange urgent transfer to a stroke centre

Answer

Start aspirin 300 mg and observe for 24 hours

Answer

Delay treatment until MRI confirms infarction

Answer

Start dual antiplatelet therapy without thrombolysis

Answer

Discharge home with outpatient review in one week

Practice question

A 64-year-old woman with sudden onset right-sided weakness and aphasia presents to a rural emergency department 1.5 hours after symptom onset. CT brain shows no haemorrhage. NIH Stroke Scale score is 12. There is no contraindication to thrombolysis. What is the most important next step?