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Updated: Mar 14, 2026

Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
Thrombolysis in dementia patients with acute stroke: is it justified?
Maurizio Paciaroni1, Leonardo Pantoni2
1Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Santa Maria della Misericordia Hospital, 06126, Perugia, Italy. maurizio.paciaroni@unipg.it.
Abstract:
The administration of thrombolytic therapy in elderly patients with dementia and acute ischemic stroke may be controversial, because the reported risk of rt-PA associated intracerebral hemorrhage in these patients is higher compared with that of patients without dementia and because these patients are already disabled. Moreover, there are known risk factors for hemorrhagic transformation in patients with dementia: amyloid angiopathy, leukoaraiosis and the presence of microbleeds. In this review, we describe the impact of dementia on functional outcome following thrombolytic therapy for acute ischemic stroke and discuss some of the issues related to the use of this therapy in this specific patient's population.
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