Case 1
A 65 year old man, who has long standing hypertension on medication, brought by his family complaining that he developed right side weakness and unable to talk for the last two hours. Your examination reveals moderate to severe hemiparesis and motor aphasia. His NIHSS is 16 and his blood pressure is 160/100.
This is his CT Scan of the brain (click on picture to enlarge):
What would your best response to the case be ?
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IV thrombolysis is contraindicated because of his elevated blood pressure.
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IV thrombolysis is contraindicated because of the CT Scan findings.
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IV thrombolysis should be administered with out delay.
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Aphasia is a contraindication to thrombolysis.
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The NIHSS indicates a severe neurological deficit, which is a contraindication to thrombolysis.