Tenecteplase (TNK) in the Treatment of Intracerebral Hemorrhage (ICH)

You may not qualify if:

• Presence of infratentorial parenchymal bleeding.
• Presence of a hemorrhage extending to the midbrain.
• An unknown time of onset or the symptoms onset more than 24 hours prior to admission.
• Pregnancy.
• Inability to obtain written informed consent from subject or legal representative.
• Sustained SBP \>180 mm Hg for six hours recorded closest to the time of drug administration.
• Age \<18 and \>80 years.
• Radiological evidence of arterio-venous malformation, aneurysm, amyloid angiopathy, Moyamoya disease, hemorrhagic conversion of an ischemic stroke, recurrent hemorrhage in the same location within the past 365 year or unstable mass as a source for the ICH.
• Evidence of coagulopathy (international normalized ratio \>1.3; platelet count \<100 ,000 or platelet dysfunction P2Y-12 \>250) or known clotting disorder.
• Bilateral fixed, dilated pupils indicating irreversible impaired brain stem function with GCS ≤4.
• Patients with severe ICH and IVH who require an external ventricular drain (EVD) placement for cerebrospinal fluid (CSF) diversion or separate intraventricular thrombolysis.
• Inability to maintain INR less than 1.3.
• Use of anticoagulants prior to symptom onset and subjects requiring long-term anticoagulants (the reversal is permitted if the patient can tolerate the short-term risk of reversal).
• Use of Dabigatran, Apixaban, and/or Rivaroxaban (or a similar medication from the similar medication class) prior to symptom onset.
• Internal bleeding (GI, renal, respiratory etc).
• +9 more criteria