Thrombolysis: contraindications

Evidence-based neurology checklist on thrombolysis: contraindications: Bleeding-related Intracranial haemorrhage (ICH) Subarachnoid haemorrhage (SAH) Active internal bleeding Arteriovenous malformations (AVMs) Some brain tumours >10 cerebral microbleeds Bleeding diathesis International normalised…

Bleeding-related

  • Intracranial haemorrhage (ICH)
  • Subarachnoid haemorrhage (SAH)
  • Active internal bleeding
  • Arteriovenous malformations (AVMs)
  • Some brain tumours
  • >10 cerebral microbleeds
  • Bleeding diathesis
  • International normalised ratio (INR) >1.7
  • Platelet count <100,000/ cubic mm

Subject-related

Drug-related

Imaging-related

Non-contraindications

References

  1. Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ 2020; 368:l6983.
  2. Frank B, Grotta JC, Alexandrov AV, et al. Thrombolysis in stroke despite contraindications or warnings? Stroke 2013; 44:727-733.
  3. Berge E, Whiteley W, Audebert H, et al. European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J 2021; 6:I-LXII.
  4. Polymeris AA, Curtze S, Erdur H, et al; TRISP Collaborators. Intravenous thrombolysis for suspected ischemic stroke with seizure at onset. Ann Neurol 2019; 86:770-779.

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