Case Steven Q8: The blood test results are normal, and the CT scan describes an ASPECTS score of 9, with a small hypodense zone in the left parietal lobe near the cortex, corresponding to the patient’s symptoms of right-sided weakness and slurred speech. What is the next step in the treatment choice?

Correct answer is A: Administer intravenous thrombolysis (tPA) In the context of an acute ischemic stroke with symptoms that started within the last hour, the appropriate next step is to administer intravenous thrombolysis (tPA). Intravenous Thrombolysis (tPA): This is the standard treatment for eligible patients presenting with acute ischemic stroke within the therapeutic window (typically within 4.5 hours from symptom onset). The ASPECTS score of 9 indicates that there is a relatively small infarct, suggesting that the patient is a good candidate for thrombolytic therapy to restore cerebral blood flow and minimize neurological damage. Immediate Surgical Intervention: This is generally reserved for cases of hemorrhagic stroke or large infarcts causing significant mass effect and increased intracranial pressure, neither of which is indicated by the CT findings in this case. Oral Anticoagulation Therapy: While anticoagulants are used for preventing stroke in patients with conditions such as atrial fibrillation, they are not the immediate treatment for an acute ischemic stroke and are contraindicated in the acute phase of thrombolysis. Initiate Rehabilitation Therapy: Rehabilitation is an important part of post-stroke care but is not the immediate next step in the acute management of stroke. It is initiated after the acute treatment phase to help the patient recover and regain function. Give Aspirin: While aspirin is used as an antiplatelet agent to prevent further clot formation in ischemic stroke, it is not the first-line treatment in the acute setting when thrombolysis is an option within the therapeutic window.