What are the contraindications for IV alteplase for otherwise eligible patients with mild nondisabling stroke?
IV alteplase is not recommended for patients with mild nondisabling stroke (NIHSS score 0-5) who could be treated within 3-4.5 h of ischemic stroke symptom onset or patient last known well or at baseline state. It is also not recommended for patients whose CT brain imaging exhibits extensive regions of clear hypoattenuation, who present with a prior ischemic stroke within 3 mo, or who have had severe head trauma within 3 mo. Finally, IV alteplase should not be administered to a patient whose CT reveals an acute intracranial hemorrhage, or in posttraumatic infarction that occurs during the acute in-hospital phase.