After administration of TPA in a stroke patient, what is used to determine whether the therapy is working?

• A. Repeat CT scan
• B. MRI
• C. EEG
• D. Ultrasound

Answer: (A)

After giving tPA for an acute ischemic stroke, the main aim of imaging is to quickly check for bleeding and confirm that reperfusion is not causing a hemorrhagic complication. A repeat non-contrast CT scan is the go-to test because it rapidly screens for intracranial hemorrhage, which would signal a complication and whether the thrombolysis is safe or not progressing as hoped. If no bleed is seen, it supports continuing careful stroke management; if a hemorrhage is detected, treatment plans change immediately.

Other choices aren’t used routinely for this immediate post-thrombolysis safety assessment in most centers: MRI can show detailed tissue status and perfusion, but it takes longer and isn’t as practical in the urgent post-treatment window; EEG isn’t helpful for evaluating thrombolysis effectiveness; ultrasound doesn’t provide intracranial hemorrhage or perfusion information needed here.