|
| Inclusion criteria for i.v. rt-PA administration: | |
| □ 1. Clinical diagnosis of acute stroke | |
| □ 2. Well-established onset less than 4.5 hours | |
| □ 3. No contra-indication for rt-PA administration as per exclusion criteria | |
| □ 4. Non-contrast CT (NCCT) brain: negative for hemorrhage | |
|
| Exclusion criteria for i.v. rt-PA administration: | |
| □ 1. Only minor stroke symptoms | |
| -Pure sensory symptoms | |
| -Ataxia only | |
| -Motor score < 1 on initial NIHSS | |
| □ 2. Major symptoms are recovered before initiation of i.v. rt-PA infusion. | |
| □ 3. Any evidence of hemorrhage in the initial NCCT. | |
| □ 4. Highly suspicious of SAH although the initial NCCT is negative. | |
| □ 5. Evidence of pregnancy | |
| □ 6. Laboratory values: | |
| -Platelet count < 100,000 | |
| -INR > 1.7 | |
| -Glucose < 50 | |
| -Hb < 10 | |
| □ 7. Major surgery or serious trauma within the last 14 days | |
| □ 8. Serious head trauma or intracranial surgery in the last 3 months | |
| □ 9. Intracranial neoplasm, arteriovenous malformation, or aneurysm | |
| □ 10. Active GI or GU bleeding or history of such bleeding within the last 21 days | |
| □ 11. Recent arterial puncture at a non-compressible site (i.e., subclavian) | |
| □ 12. Lumbar puncture within the last 7 days (including epidural/spinal anesthesia) | |
| □ 13. Persistent hypertension | |
| -Unable to lower blood pressure below 185/110 within time window of treatment | |
| -Too aggressive treatment required to reduce blood pressure below 185/110 | |
| □ 14. History of major cerebral infarction within the past three months | |
| □ 15. History of intracranial hemorrhage considered to put the patient at increased risk of intracranial hemorrhage | |
| □ 16. Concurrent serious illness | |
| □ 17. Clinical diagnosis of myocardium infarction or aortic dissection | |
| □ 18. Clinical presentation suggestive of post-myocardial infarction pericarditis | |
| □ 19. Seizures at onset of acute stroke | |
| □ 20. History or clinical/lab evidence of acute drug abuse | |
| Additional exclusion criteria for symptom onset during 3 to 4.5 hrs: | |
| □ 1. Age > 80 years | |
| □ 2. Taking Warfarin regardless of INR | |
| □ 3. Initial NIHSS > 25 | |
| □ 4. Diagnosed as diabetic mellitus with previous ischemic stroke | |
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