STROKE-tPA INCLUSION CRITERIA

SUMMARY

CRITERIA
1. Diagnosis of ischemic stroke causing measurable neurologic deficit

2. Onset of symptoms ≤ 4.5 hours (last known to be well or midpoint of sleep)

3. 9 hours if there is perfusion mismatch (Ma et al 2019, Campbell et al 2019)

4. Age > 18 years

5. CTB negative for ICH

6. Informed consent of the patient

EVIDENCE
In the National Institute of Neurologic Disorders (NINDS) trial (1995), patients given tPA within 3 hours of onset of stroke were 30% more likely to have minimal or no disability at 3 months compared to patients treated with placebo. Wardlaw et al. 2014, Emberson et al. 2014 demonstrated benefit of tPA within 4.5 hours.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].