Cerebral infarction for more than 6 hours generally can not be thrombolysis, with occasional exceptions can be thrombolysis.
More than 6 hours after the onset of cerebral infarction, irreversible damage has occurred in the distal brain tissue cells supplied by the blocked cerebral blood vessels, and even if thrombolytic therapy is performed, the function of the brain cells can not be restored, and may cause reperfusion injury, increasing the risk of cerebral hemorrhage. Therefore, thrombolysis is not recommended.
Indications for thrombolysis include: age 18-80 years; onset within 4.5 hours (alteplase); signs of cerebral impairment persist for more than 1 hour and are severe; intracranial hemorrhage has been ruled out by brain CT and there are no imaging changes of early massive cerebral infarction; and the patient or family has signed an informed consent.
However, there are special cases in which patients with severe cerebral infarction caused by occlusion of posterior circulation arteries within 24 h of onset and not suitable for intravenous thrombolysis can be subjected to arterial thrombolysis after strict selection in a unit where it is available. In this case, thrombolysis is also possible within 6 to 24 hours.
Patients are advised to actively seek medical attention and be treated under the guidance of a physician.