Thrombolysis: contraindications
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Thrombolysis: contraindications. Intracranial haemorrhage (ICH), Subarachnoid haemorrhage (SAH). Fully referenced neurology checklist.
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
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Drug-related
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Imaging-related
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Non-contraindications
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References
- Phipps MS, Cronin CA. Management of acute ischemic stroke. BMJ 2020; 368:l6983.
- Frank B, Grotta JC, Alexandrov AV, et al. Thrombolysis in stroke despite contraindications or warnings? Stroke 2013; 44:727-733.
- 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.
- 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.
