clinical-caseEN
👤 Eleanor, 71, post-tPA, slightly more drowsy
NIHSS 12. tPA only (no EVT). BP trending up: 162 → 168/98. Target should be 130-140.
You notice subtle drowsiness. STAT NIHSS → 15. STAT CT → hemorrhagic transformation.
Early detection = prompt reversal = better recovery.
⚠️ Never dismiss subtle neuro changes post-tPA as "patient tired from ordeal."