ZyraDoc #21 - August 22, 2026

A 68-year-old man presents with sudden-onset right-sided facial droop, right arm weakness, and expressive aphasia that began 90 minutes prior to arrival.

Non-contrast head CT demonstrates no evidence of intracranial hemorrhage or early ischemic changes, and blood glucose is 112 mg/dL.

The clinical team discusses lowering his blood pressure of 168/94 mmHg down to 120/80 mmHg before initiating acute reperfusion therapy.

Case Summary

Clinical Focus:

A 68-year-old male presents with acute ischemic stroke within the 4.5-hour therapeutic window eligible for intravenous thrombolysis.

Diagnostic Features of Acute Ischemic Stroke:

Sudden focal neurological deficits (facial palsy, arm drift, abnormal speech)
Non-contrast head CT ruling out acute intracranial hemorrhage
Blood glucose checked to exclude hypoglycemia mimic (> 50 mg/dL)

In patients presenting within 4.5 hours of symptom onset without hemorrhage on CT, immediate IV thrombolysis is indicated.

Here is the Management Strategy:

You've already played this ZyraDoc! Try out others from the Archives, or come back tomorrow for a new one!

Incorrect!

Correct!

Please pick from the selection list or skip

1/3.

✗

2/3.

✗

3/3.

✗

What's the Best Next Step?

Case Summary

Reset Password

Verify Your Account

Verify Your Account