Potential Hazards of Thrombolysis for Mild Stroke

Thrombolysis was associated with higher rates of brain hemorrhage and deterioration in patients with mild strokes.

The potential role of intravenous thrombolysis (IVT) for patients with acute, mild ischemic strokes is controversial. With recent positive trials of dual antiplatelet therapy for mild stroke, comparative data are welcome. However, recent studies have excluded patients with mild but potentially disabling symptoms, such as aphasia or hemianopia (NEJM JW Neurol Jul 13 2023 and JAMA 2023; 329:2135).

These authors reviewed data from a prospective, nationwide registry in Austria to identify patients with mild stroke, defined as a NIH Stroke Scale (NIHSS) score of 3 or less. Patients with cardioembolic strokes or atrial fibrillation, those treated with antiplatelet monotherapy, and those missing 3-month outcome data were excluded. The authors compa…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Potential Hazards of Thrombolysis for Mild Stroke

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Reviewing Author