Can Older Patients with Acute Ischemic Stroke Be Treated Safely with Thrombolysis?

JE Simon, MB, ChB, MRCP (UK), Calgary Stroke Program, Seaman Family MR Research Centre, Department of Clinical Neurosciences, University of Calgary, Calgary, AB.
MD Hill, MD, MSc, FRCPC, Director, Stroke Unit, Associate Professor, Calgary Stroke Program, Departments of Clinical Neurosciences / Medicine / Community Health Sciences, University of Calgary, Calgary, AB.

Despite the fact that stroke is both common and devastating in older patients, very little randomized controlled data is available on the efficacy or safety of thrombolysis in older age groups. We review literature from both randomized control studies and case series data treating older patients, and look at the hemorrhage rate and mortality associated with thrombolysis. In addition, we examine risk markers, other than age, for a poor outcome. We suggest that older age alone is not a contraindication to thrombolytic therapy.

Key words: ischemic stroke, tPA, thrombolysis, hemorrhage risk.