Acute Stroke – LKN 3-4 half hr

If Last known normal between 3-4.5 hours

Evaluate risks and benefit of TPA

If any of the following, no tpa

  • over 80 years old
  • taking oral anticoagulant
  • NIHSS > 25
  • Previous Stroke plus Diabetes
  • Imaging study showing evidence of injury over 1/3 of MCA territory