Question

A 68-year-old man presents with sudden onset right-sided weakness and dysarthria that began 90 minutes ago. CT head shows no haemorrhage. Blood pressure is 165/95 mmHg, and glucose is 6.2 mmol/L. There are no contraindications. According to stroke guidelines, what is the most appropriate next step?

Accepted Answer

Begin intravenous thrombolysis with alteplase

Answer

Delay thrombolysis until MRI confirms infarct

Answer

Start therapeutic heparin infusion

Answer

Give aspirin 81 mg and delay thrombolysis for 24 hours

Answer

Discharge for outpatient carotid ultrasound and neurology review

Practice question

A 68-year-old man presents with sudden onset right-sided weakness and dysarthria that began 90 minutes ago. CT head shows no haemorrhage. Blood pressure is 165/95 mmHg, and glucose is 6.2 mmol/L. There are no contraindications. According to stroke guidelines, what is the most appropriate next step?