Warning

A quick but thorough assessment is required for patients who arrive out of hours.  There is a lot of information to get through, but all of this is required to make a decision about the possible need for thrombolysis.  Some key points are:

  • Time of onset - this is the most important factor in deciding for thrombolysis
  • Remember to check for inattention - both visual and sensory
  • A lactate from a venous gas can give some indication of whether a patient is post-ictal and suffering from Todd's paresis
  • Every 10 minutes of time to treatment in acute stroke leads to 1 month of loss of life

Editorial Information

Next review date: 01/06/2026

Reviewer name(s): Kim Kilmurray.