Exclusion criteria

Exclusion criteria for use of intravenous tissue plasminogen activator

Evidence of intracranial hemorrhage or early changes of major infarction on pretreatment computed tomography
Current use of oral anticoagulants or prothrombin time >15 sec (international normalized ratio >1.7)
Heparin use within previous 48 hr and prolonged activated partial thromboplastin time
Platelet count <100,000/mm3
Another stroke or head trauma resulting in loss of consciousness within previous 3 mo
Major surgery within previous 14 days
Pretreatment systolic blood pressure consistently >185 mm Hg
Pretreatment diastolic blood pressure consistently >110 mm Hg
Rapidly improving neurologic deficit
Isolated mild neurologic deficit (eg, single limb ataxia, hemisensory loss)
Any history of intracranial hemorrhage
Serum glucose <50>400 mg/dL
Seizure at onset of stroke
Gastrointestinal or urinary tract bleeding within previous 21 days
Recent myocardial infarction
Arterial puncture at noncompressible site within previous 7 days


Adapted from Quality Standards Subcommittee of the American Academy of Neurology (5).