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Ischemic stroke thrombolysis beyond the 4.5-hour window: who qualifies with advanced imaging?

Prabhu Kvn
Prabhu Kvn
Other
πŸ‘ 23 viewsπŸ’¬ 0 answersπŸ• Apr 14, 2026
⚠For peer discussion only β€” not a substitute for clinical judgment. Always verify with authoritative sources.

A 67-year-old patient woke up with right-sided hemiparesis and aphasia. Time last known well is 9 hours ago. NIHSS is 12. MRI DWI shows small core infarct with large penumbra on perfusion imaging (RAPID software showing mismatch ratio > 1.8). Is extended-window thrombolysis with alteplase appropriate here? What do DAWN and DEFUSE 3 trial criteria say about patient selection for late-window thrombectomy?

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πŸ• Asked Apr 14, 2026
Asked by
Prabhu Kvn
Prabhu Kvn
Other
⭐ 48 reputation
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