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Title: Brain CT Finding that Contraindicates tPA for Acute Ischemic Stroke

Category: Neurology

Keywords: tpa. stroke, brain CT (PubMed Search)

Posted: 12/16/2009 by Aisha Liferidge, MD (Updated: 3/4/2026)

  • Frank hypointensity (i.e. dark hue) on CT of the brain, particularly if involving greater than one-third of the middle cerebral artery (MCA) territory, is a contraindication to treating acute ischemic stroke with tPA.
  • Early signs of infarct on brain CT, regardless of extent, are NOT contraindications to treatment.

References

  • Latchaw et al.  Recommendations for imaging acute ischemic stroke:  A scientific statement from the American Heart Association. Stroke 2009;40:3646-78.