Which finding would generally exclude using IV thrombolysis in suspected ischemic stroke?

• A. Suspected intracranial hemorrhage on imaging
• B. Normal CT scan
• C. Blood pressure 120/80
• D. Mild symptoms resolving spontaneously

Answer: (A)

The main idea is that IV thrombolysis (tPA) is given to dissolve a clot in acute ischemic stroke, but it carries a high risk of bleeding. If imaging shows an intracranial hemorrhage, administering a clot-busting drug would worsen the bleeding inside the brain and can be life-threatening, so this finding would generally exclude IV thrombolysis. Other scenarios here do not pose the same absolute risk: a normal CT scan means there is no bleed, so treatment can proceed if other criteria are met; a blood pressure of 120/80 is within the safe range for thrombolysis; and mild symptoms that are resolving on their own are not an absolute contraindication, though they may influence the decision to treat in some cases.