Curriculum · Neurology
Contraindications to thrombolysis in acute stroke
What it is
The contraindications are:
- Stroke or serious head trauma within 3 months.
- Hemorrhage, GI or genitourinary, within 21 days.
- Surgery within 14 days.
- A history of intracranial hemorrhage.
- BP above 185/110 mm Hg.
- Current use of anticoagulants.
- Platelets under 100,000/mm3, or coagulopathy with a PT above 15 seconds.
Three of them are time bound and are read from the date rather than from the patient in front of you: the stroke or serious head trauma at 3 months, the GI or genitourinary hemorrhage at 21 days, and the surgery at 14 days. The rest are read at the bedside or off the chart: the BP, the current anticoagulants, the platelet count and the PT, and any history of intracranial hemorrhage at all, with no time limit on it.