Ace the Hemisphere IV Stroke Response Challenge 2026 – Think Fast, Save Lives!

IV alteplase is given only when the stroke is suspected to be ischemic and the benefits of dissolving the clot outweigh the bleeding risk, which depends on time, imaging, and safety factors. The statement that best fits this balance says you must treat within four and a half hours of onset, there is no intracranial hemorrhage on the CT, and there are no major contraindications. The four-and-a-half-hour window is supported by evidence showing better outcomes with earlier treatment; a six-hour window is not standard practice for initial IV tPA. A CT without hemorrhage is essential because tPA increases bleeding risk, so confirming there’s no bleed is a critical safety check. “No major contraindications” covers other high-risk situations (like uncontrolled hypertension, recent major surgery or bleeding risk, or severe coagulopathy) that would make tPA inappropriate. The other options misstate the time window, impose unnecessary imaging requirements, or rely on age alone, which does not capture the full safety and timing criteria used in practice.