In general, only patients with strokes almost certainly due to cardiogenic embolism or thromboembolism from atheromatous disease should be considered.

Contra-indications to rTPA treatment are listed in Table 2. (See Supplemental Materials)

• Young patients should be treated with particular caution, as their stroke could be due to unusual etiologies.
  
• rTPA should not be used in patients with minor or rapidly improving stroke, since they have less to gain and much to lose from this therapy.

Copyright 2000