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SEDAN Score for Post-tPA Hemorrhage

Predicts risk of Symptomatic Intracerebral Hemorrhage (sICH) after tPA.

Applies to patients not undergoing endovascular treatment, tPA within 4.5 hours.

Advice

  • Consider tPA contraindications closely, as institutions may have slightly different definitions of contraindications (absolute and relative).
  • tPA for stroke should only be given in conjunction with Neurology consultation and after extensive discussion with the patient and family about risk and benefit.
  • Patients receiving tPA should be monitored in an ICU setting.
  • Even in low-risk patients, patients with changing neurologic exams or mental status should receive emergent re-imaging to assess for sICH.
  • Consider other bleeding sites (GI, GU, for example) in post-tPA patients and exercise caution with even minimally invasive procedures such as venipuncture or foley catheter placement.