Now 1 hr 30 mins (90 mins) since onset, BP currently 130/90, NIHSS unchanged at 8.
What would you do next?
Request further advanced imaging (e.g. CTP, MRI, MRP) to guide treatment?
CTP normal CBF, 0 ml TMax greater than 6, however entire right hemisphere abnormality TMax >4sec.
Does not respect territories and CTA: no CC, ICA, MCA, ACA or PCA occlusion. ? Stroke mimic seizure, or hemiplegic migraine.
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 BP intervention.
Any lysis intervention?
- No lysis
- Treat with alteplase 0.9mg/kg
- Treat with alteplase 0.6mg/kg
- Treat with tenecteplase
None of our experienced colleagues recommended lysis.
Refer for thrombectomy?
- Yes
- No
None of our experienced colleagues recommended referral for thrombectomy.
