Would you recommend TNK or DAPT in patients with stroke-like symptoms and NIHSS less than 5 presenting within 4.5 hours?

I agree with Dr. @Dr. First Last. The decision in patients with minor stroke rests on whether the symptoms are disabling, which in general, is based on a discussion with the patient and their family to understand how the deficit could impact the patient's career or hobbies. For disabling deficit, I ...

The operative principle issue here is not the total NIHSS score but whether or not the deficit would be disabling if it did not recover. A hemianopia, for example, would be only two points on the NIHSS, but it might be disabling to a pilot or a surgeon. If one is not inclined to treat, the PRISMS tr...

I agree with Dr. @Dr. First Last, but just to clarify, the ARAMIS trial showed DAPT to be non-inferior to alteplase. The trial was specifically conducted for minor non-disabling strokes. DAPT therapy consisted of aspirin and clopidogrel for 12 days. In the primary outcome of frequency of mRS 0-1, DA...

I always look for a reason to give thrombolytics and not withhold them! A significant number of patients that the ER deemed too "good" to receive thrombolytics struggled to regain their previous level of functioning.