Now 2 hrs 20 mins (140 mins) since onset, BP currently 158/90, NIHSS unchanged at 6.
What would you do next?
Request further advanced imaging (e.g. CTP, MRI, MRP) to guide treatment?
CTP perfusion deficit, low mismatch volume, ratio not favourable from a treatment perspective.
Any BP intervention?
- No BP intervention
- Lower SBP to <180mmHg before bolus
- Start lowering BP, but give bolus before attaining target
None of our experienced colleagues recommended GP intervention.
Any lysis intervention?
- No lysis
- Treat with alteplase 0.9mg/kg
- Treat with alteplase 0.6mg/kg
- Treat with tenecteplase
3/5 of our experienced colleagues recommended alteplase 0.9mg/kg, 2/5 recommended no lysis.
Refer for thrombectomy?
- Yes
- No
None of our experienced colleagues recommended referral for thrombectomy.
