A patient who is possibly experiencing a stroke is NOT eligible for thrombolytic therapy if he or she:

• A. has bleeding within the brain.
• B. GCS score < 8.
• C. is older than 60 years of age.
• D. has had a prior heart attack.

Answer: (A)

Thrombolytic therapy is used for acute ischemic stroke, but it must be avoided if there is bleeding in the brain. An intracranial hemorrhage is an absolute contraindication because agents like tPA would worsen the bleed, increasing the risk of fatal expansion and brain damage. That’s why the presence of bleeding within the brain makes the patient not eligible for thrombolysis. Other options—such as a low GCS score, age over 60, or a prior heart attack—do not by themselves rule out treatment; eligibility hinges on imaging to exclude hemorrhage, time from onset, blood pressure, and other factors. A CT scan is typically done first to confirm there is no intracranial bleeding before proceeding with thrombolysis.