Table 1 Contraindications of thrombolysis [8]

Absolute contraindications

History of severe head trauma within the last 3 months

Symptoms suggestive of subarachnoid hemorrhage

History of intracerebral hemorrhage

Intracranial/spinal surgery within the last 3 months

Infective endocarditis

Aortic dissection

Increased blood pressure (systolic > 185 mmHg or diastolic > 110 mmHg) refractory to lowering by medication

Active internal bleeding

Acute bleeding diathesis:

 Platelet count < 100,000/mm³

 Consumption of heparin within 48 h, with an increase in aPTT (> 40 s)

 Consumption of low-molecular-weight heparin with the last dose within 24 h

 Use of anticoagulants with an INR > 1.7 or PT > 15 s

 Use of thrombin inhibitors or factor Xa inhibitors

CT demonstrates an infarction (hypodense lesion) > 1/3 of a cerebral hemisphere

CT demonstrates acute intracerebral hemorrhage

Relative contraindications

Mild stroke symptoms or rapid improvement in stroke symptoms

Very severe neurological deficits (NIHSS score > 25) within the window period of 3 to 4.5 h

Pregnancy

Seizures at onset

Arterial puncture in a noncompressible locations within the last 7 days

Untreated intracranial arteriovenous malformations

Untreated intracranial giant aneurysms

History of major surgery or serious trauma within the last 14 days

History of gastrointestinal or urinary tract bleeding within the last 21 days

History of ischemic stroke within the last 3 months

History of STEMI within the past 3 months

Blood glucose levels < 50 mg/dL