Ischemic Stroke

A 58-year-old man with hypertension and diabetes presents to the emergency department 2.5 hours after onset of acute left-sided weakness and slurred speech. On examination, he has a National Institutes of Health Stroke Scale (NIHSS) score of 8. CT head (non-contrast) shows no hyperdensity or hypodensity. Blood glucose is 180 mg/dL. What is the most appropriate immediate next step in management?

A 72-year-old woman with atrial fibrillation (not on anticoagulation) presents 6 hours after sudden onset of right-sided hemiparesis and aphasia. Non-contrast CT head is normal. MRI DWI shows acute infarction in the left middle cerebral artery territory. She is ineligible for IV thrombolysis due to recent hip surgery (8 days ago). What is the most appropriate next step in management?

A 58-year-old man with hypertension and diabetes presents to the emergency department 2 hours after onset of acute ischemic stroke confirmed on CT head. His NIHSS score is 8. What is the drug of choice for acute reperfusion therapy?

A 58-year-old man presents with acute onset left-sided weakness and facial droop of 2 hours duration. Non-contrast CT head is normal. What is the investigation of choice to confirm acute ischemic stroke and guide thrombolytic therapy?

A 58-year-old man from Delhi presents to the emergency department with acute onset of right-sided weakness and slurred speech that began 90 minutes ago. His wife reports he was watching television when he suddenly couldn't speak clearly and his right arm went limp. On examination: BP 168/98 mmHg, HR 92/min regular, temperature 37.2°C. Neurological exam shows right facial droop, right arm power 2/5, right leg power 3/5, and expressive aphasia. CT head (non-contrast) is normal. Blood glucose is 118 mg/dL. What is the most appropriate next step in management?