Stroke Training and Awareness Resources (STARs)


04: Update and decisions

Now 1 hr 40 mins (100 mins) since onset, BP currently 170/74, NIHSS improved from 12 to 9 – improved power in arm and leg.

What would you do next?

Request further advanced imaging (e.g. CTP, MRI, MRP) to guide treatment?

CTP normal.

Any BP intervention?

  • No BP intervention
  • Lower SBP to <180mmHg before bolus
  • Start lowering BP, but give bolus before attaining target

None of our experienced colleagues recommended BP intervention.

Any lysis intervention?

  • No lysis
  • Treat with alteplase 0.9mg/kg
  • Treat with alteplase 0.6mg/kg
  • Treat with tenecteplase

4/5 recommended alteplase 0.9mg/kg, 1/5 recommended no lysis.

Refer for thrombectomy?

  • Yes
  • No

None of our experienced colleagues recommended referral for thrombectomy.