A 65-year-old patient of CAD develops sudden onset right side face and arm weakness and expressive dysphasia. On admission BP= 160/100 mm Hg. NCCT was done. Which is the best step in the management of this patient?
NCCT head shows Hyderdense MCA sign of acute ischemic stroke. Hyperdense MCA sign- increased density within the middle cerebral aery on a non-contrast CT of the brain due to the presence of acute thrombus. This is one of the few signs that my be identified during the first few hours (hyperacute phase) of MCA territory infarction. Acute ischemic stroke: This sign indicates thrombus in the aery and is a early sign seen in cases of A.I.S. Before evolution of wedge shaped hypodensity . I/V Nicardipine & I/V Labetalol are not required as BP is not in range of Hypeensive crisis. Lowering this BP will reduce cerebral perfusion and worsen the patient. Rx- Mannitol is given when features of raised ICP are present. Best step is thrombolysis with Reteplase.
Intravenous Nicardipine
Intravenous Labetalol
Intravenous Reteplase
Intravenous Mannitol
Stroke and TIA