Mazya MV, Lees KR, Collas D, et al. IV thrombolysis in very severe and severe acute ischemic stroke. Results from the SITS/ISTR registry. Neurology 2015; 85:20898-2106 (also editorial).
Authors study a large number of patients with severe strokes and find that iv alteplase does not affect their chances of developing a hemorrhage. There also was no difference in treatment benefit compared to those with lower NIHSS scores.
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