Case presentation An 85-year-old woman presents to the emergency room within an hour of the onset of right hemiplegia and global aphasia. She has no significant medical history, and her laboratory data are normal. Neuroimaging shows no signs of hemorrhage and acute ischemia.

However, the emergency room physician is unsure whether to give intravenous tissue plasminogen activator (tPA). He asks for your recommendation on giving intravenous tPA. Source: Neurology WebMD