INCLUSION CRITERIA FOR 0–4.5 HOURS |
History |
Exact time of stroke onset |
No head trauma, stroke or MI within 3 months |
No gastrointestinal- or urinary tract bleeding within 21 days |
No major surgery within 14 days |
No arterial puncture at a noncompressible site within 7 days |
No history of intracranial hemorrhage |
Examination |
Measurable neurological impairment without spontaneous improvement |
No active bleeding or evidence of acute trauma |
No seizure at stroke onset |
No evidence of postictal condition |
No symptoms of subarachnoid bleed present |
Labs/vitals |
INR ≤1.7 |
Heparin use in previous 48 h, aPTT in normal range |
aPTT normal |
Platelet count ≥100 000/ml |
Serum glucose ≥50 mg/dl |
Systolic blood pressure <185 mmHg |
Diastolic blood pressure <110 mmHg |
Head CT/imaging |
No intracranial hemorrhage |
No hypodensity/ischemia involving >1/3 cerebral hemisphere |
ADDITIONAL EXCLUSION CRITERIA FOR 3.0–4.5 HOURS |
Age older than 80 years |
Oral anticoagulation therapy, irrespective of INR |
Baseline NIHSS >25 |
History of both diabetes and stroke |
aPTT, activated partial thromboplastin time; INR, international normalized ratio; MI, myocardial infarction; NIHSS, National Institutes of Health Stroke Scale.