Neurology & Special Senses

Non-contrast head CT to rule out hemorrhage before considering thrombolysis.

Within 4.5 hours of symptom onset, if no contraindications (e.g., recent surgery, bleeding, very high BP).

For large-vessel occlusion, can be done up to 24 hours from onset in selected patients with favorable imaging.

Aspirin started after hemorrhage excluded (and 24 h after tPA if given); add statin.

Carotid ultrasound (or CTA), echocardiogram, and telemetry/Holter to detect atrial fibrillation.

Hemorrhagic transformation and cerebral edema.