Should we exclude acute stroke patients with previous intracerebral hemorrhage from receiving intravenous thrombolysis

BackgroundCurrent guidelines have contraindicated history of intracerebral hemorrhage for intravenous recombinant tissue plasminogen activator.AimThis study aimed to investigate the safety and effectiveness of intravenous recombinant tissue plasminogen activator for patients who had previous intracerebral hemorrhage on history or initial brain magnetic resonance imaging.MethodsUsing a prospective multicenter stroke registry database, we identified acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator within 4.5 h of onset. Previous intracerebral hemorrhage was defined as having a clinical history or evidence of old intracerebral hemorrhage on initial brain magnetic resonance imaging. Associations of previous intracerebral hemorrhage with symptomatic hemorrhagic transformation during hospitalization and functional outcome and mortality at discharge and three months were analyzed.ResultsAmong 1495 patients who were treated with intravenous recombinant tissue plasmi...