BACKGROUND: Rapidly improving or mild symptoms is the most common reason that acute @entity64 @entity1 arriving within the approved time window are not treated with intravenous tissue-type plasminogen activator (IV tPA). We reviewed outcomes at discharge for @entity1 excluded from IV tPA because of rapidly improving or mild symptoms, with the aim of being better able to identify @entity1 who may benefit from thrombolysis. METHODS: All @entity1 between April 2006 and June 2010 from our center who did not receive IV tPA with "rapidly improving or mild symptoms" as the reason for exclusion were identified. Poor outcome was defined as hospital discharge to location other than home or inability to ambulate independently at discharge. RESULTS: There were 66 @entity1 excluded from tPA treatment because of rapidly improving or mild symptoms. Eleven @entity1 (16.7%) had poor outcomes. In 6 @entity1 (9%), poor outcome was due to @entity51 . All 6 @entity1 with @entity51 had right hemisphere @entity64 , and one also had @entity1188 . CONCLUSIONS: @entity1 presenting with rapidly improving or mild symptoms do not universally have good outcomes. This may be particularly true in the case of right hemispheric @entity63 where deficits are not fully reflected by NIHSS score. If a @entity1 with a low NIHSS score is otherwise a candidate for tPA, a more detailed exam is warranted to better identify potentially disabling deficits that might benefit from thrombolysis.

Right Hemisphere XXXX is more likely to Cause Falsely "Mild" Symptoms and Poor Outcomes without Thrombolysis.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity64 :: ('MESH:D020521', 'Disease') :: ['strokes', 'stroke'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity51 :: ('MESH:D009461', 'Disease') :: ['neurologic deficit', 'neurologic deficits'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['cerebellar infarcts']
@entity63 :: (MESH:D007511,Disease) :: ['Ischemia']
