Case 25: Sudden Fall and confusion

MBBS
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1

A 67-year-old man is brought to the ER after a sudden fall. He has slurred speech, right-sided weakness, and facial droop. BP: 180/100 mmHg. CT shows no hemorrhage.

Question:
What is the most appropriate next step in management?
A. Start aspirin immediately
B. Administer IV mannitol
C. Begin thrombolysis with tPA
D. Order MRI brain with contrast

2

Since it is an emergent situation Option C should be the ideal answer. :thinking:

3

Since there’s no bleeding on the scan, the best move is to give tPA right away—it can help dissolve the clot and restore brain function.