A 72 yo m comes to ER due to sudden onset of right sided wea

[madhurima]

A 72 yo m comes to ER due to sudden onset of right sided weakness, aphasia and incontinence. He did not loose consciousness. All his symptoms started suddenly an hour ago. He was previously diagnosed with hyperlipidemia and is on statin. He is a known smoker and alcoholic. He is taking aspirin as prophylaxis for heart attack and strokes. His Family history is not significant. His BP is 160/88, pulse 78/min, resp 18/min, temp 100 deg F. He is admitted and a patent airway is secured. The cardiac examination and EKG findings are normal. Ct of the brain shows no acute hemorrhage. Which intervention will result in the best outcome in this patient?

a. IV Nitroprusside to reduce BP

b. Nimodipine

c. Tissue plasminogen activator within 3 hours

d. Streptokinase and heparin combination

e. IV high dose corticosteroid

[madhurima]

It's C, This patient had stroke, in first 24 hours, do a CT to rule out any hemorrhage, in which aspirin and t-PA are contraindicated. In this patient, CT didnt show any hemorrhage.