All of the following are indications for thrombolysis in a patient with stroke except:
(A) Age <18 years (B) Sustained BP >185/110 mm Fig despite treatment (C) On CT scan, edema less than 1/3rd of middle cerebral aery territory (D) Acute ischemic stroke within 3 hours of onset
(B) Ans: B. Sustained BP >185/110 mm Fig despite treatment(Ref: Harrison 19/e p759, 1605, 18/e p3273)A sustained BP >185/110 mull Hg despite treatment is a contraindication for thrombolytic therapy as it may lead to hemorrhage. Administration of IV Recombinant Tissue Plasminogen Activator (PA) for Acute Ischemic Stroke:IndicationContraindicationClinical diagnosis of strokeOnset of symptoms to time of drug administration <3 hoursCT scan showing no hemorrhage or edema of >1/3 of the MCA territoryAge > 18 years Sustained BP >185/110 mm Hg despite treatmentPlatelets <100,000; HCT <25%; glucose <50 or>400 mg/dLUse of heparin within 48 hours & prolonged PTT, or elevated INR