Focal neurological deficit from cerebral vessel occlusion.
Investigations
- • Non-contrast CT (exclude bleed)
- • CT angiography (LVO for thrombectomy)
- • Glucose, coag, ECG, troponin
Management
- • Thrombolysis with alteplase 0.9 mg/kg (max 90) if <4.5 h and no contraindications
- • Tenecteplase 0.25 mg/kg (max 25) alternative
- • Mechanical thrombectomy for LVO up to 24 h (imaging-selected)
- • Aspirin 300 mg from 24 h post-lytic
- • BP <185/110 pre-lytic; <220/120 otherwise
Complications
- • Haemorrhagic transformation, cerebral oedema
Related in WardRound
Educational — verify locally.
