Part 2: Ischemic Stroke: Evaluation, Treatment, and Prevention

Matthew Brandon Maas, MD, and Joseph E. Safdieh, MD

Dr. Maas is a fellow in Stroke and Neurocritical Care, Harvard Medical School, Departments of Neurology, Massachusetts General and Brigham and Women’s Hospitals, Boston, MA. Dr. Safdieh is an assistant professor of neurology, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY.

Question 5

Emergent noncontrast head computed tomography (CT) scan and CT angiography are performed. The time is currently 6:30 pm. Which piece of clinical data would deter administration of intravenous tissue plasminogen activator (tPA)?

  •  The patient’s NIHSS is greater than 12
  •  The patient’s platelet count is 87,000 cells/mm3
  •  The patient’s international normalized ratio (INR) is 1.65
  •  The patient had knee surgery 20 days ago
  •  The patient was last seen normal by his wife at 4 pm

Updated 1/12/2010 • mcf | Copyright ©2014 Turner White Communications