Absolute Contraindications

• Previous hemorrhagic stroke at any time; other strokes or cerebrovascular events within 1 year
• Known intracranial neoplasm
• Active internal bleeding (except menses)
• Suspected aortic dissection

 Cautions: Relative Contraindications

• Severe uncontrolled hypertension at presentaion (BP > 180/110)
• Other intracerebral pathology
• Current use of anticoagulants (INR > 2-3), known bleeding diathesis
• Recent trauma (2-4 weeks), including head trauma
• Prolonged ( > 10 min) and potentially traumatic CPR
• Major surgery ( < 3 weeks prior)
• Noncompressible vascular punctures
• Recent (2-4 weeks) internal bleeding
• For streptokinase/anistreplase: prior exposure (especially in previous 2 years); prior allergic reaction to streptokinase
• Pregnancy
• Active peptic ulcer
• History of chronic severe hypertension