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Updated: Jul 31, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Thrombolysis in patients with transient neurologic deficits
1Department of Neurosciences, UCSD School of Medicine, San Diego, CA, USA. plyden@ucsd.edu
Abstract:
What is the risk of thrombolysis in patients with acute stroke who might recover without treatment? In the National Institute of Neurological Disorders and Stroke rt-PA for Acute Stroke Trial, 2.6% of patients taking placebo showed spontaneous 24-hour recovery, compared to 11.5% of recombinant tissue-type plasminogen activator (rt-PA)-treated patients (p < 0.001). There were no symptomatic ICH in the patients taking placebo; one hypertensive, rt-PA-treated patient hemorrhaged. Assuming the National Institute of Neurological Disorders and Stroke protocol is followed rigorously, patients with acute stroke rarely recover spontaneously and the thrombolytic risk is low.
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