Administration of Intravenous Recombinant Tissue Plasminogen Activator (Rtpa) for Acute Ischemic Stroke (Ais)

Indication Contraindication Clinical diagnosis of stroke Onset of symptoms to time of drug administration <3 h CT scan showing no hemorrhage or edema of >1/3 of the MCA territory Age >18 years Consent by patient or surrogate Sustained BP >185/110 mm Hg despite treatment Platelets <100,000;  HCT <25%;  glucose <50 or >400 mg/dL Use of heparin within 48 h and prolonged PTT, or elevated INR Rapidly improving symptoms Prior stroke or head injury within 3 months; prior intracranial hemorrhage Major surgery in preceding 14 days Minor stroke symptoms Gastrointestinal bleeding in preceding 21 days Recent myocardial infarction Coma or stupor