A 67-year-old man with hypertension and atrial fibrillation presents with acute onset left facial droop and arm weakness. Vital signs: BP 158/92 mmHg, HR 102 bpm (irregular), RR 16, SpO2 98% on room air. CT head shows no hemorrhage. Labs reveal INR 1.2. He denies recent headache or vision changes. Symptom onset was 2 hours ago. Which of the following is the most appropriate next step in management?
- A)Start aspirin and observe for 24 hours
- B)Begin warfarin therapy immediately
- C)Perform immediate mechanical thrombectomy
- D)Administer intravenous alteplaseGABARITO
- E)Obtain perfusion imaging before any intervention
Explicação
Within the 3-4.5 hour window for IV thrombolysis and without contraindications, intravenous alteplase is indicated for acute ischemic stroke. The patient is within the thrombolytic time window (2 hours) with a negative CT excluding hemorrhage. Ver explicação completa e trilha adaptativa →