Which scenario would contraindicate IV thrombolysis?

• A. Platelet count normal
• B. Onset within 3 hours and normal imaging
• C. Recent intracranial hemorrhage
• D. Blood pressure within guideline range

Answer: (C)

IV thrombolysis is used in acute ischemic stroke to dissolve clots, but it carries a bleeding risk. If there has been a recent intracranial hemorrhage, giving a thrombolytic would likely worsen the bleed and can be deadly, so it is a clear contraindication. The other scenarios don’t pose this immediate bleeding risk: a normal platelet count suggests coagulation is adequate; presenting within a few hours with normal imaging indicates eligibility rather than a contraindication; and having blood pressure within guideline targets helps reduce bleeding risk and supports proceeding when other criteria are met.