Focal Neurological Deficit: Thrombolysis

In patients being considered for thrombolysis therapy blood pressure is important. Significant elevations in BP (>185/110) is a contra-indication to this therapy [5].

In exceptional circumstances, if the BP is slightly elevated above this limit, and thrombolysis is clinically indicated, there is some evidence for controlling BP prior to administering thrombolysis.

Intravenous labetalol is the agent of choice. Careful BP control, following administration of thrombolysis, is important to prevent secondary intracranial haemorrhage.

Learning Bite

If BP control is to be attempted in the setting of stroke, then intravenous labetalol is the agent of choice.