Intravenous thrombolysis in minor ischemic stroke is controversial and often a minimum score of National Institute of Health Stroke Scale is recommended for thrombolysis. Clinical characteristics, safety and outcome of very minor ischemic stroke treated by IVT were assessed.Data of all patients treated with IVT during the last 5 years were extracted from a prospectively collected database. VMIS was defined as NIHSS=0 or 1 on admission. Baseline demographic data, symptoms, clinical and imaging findings, and outcome of VMIS patients were analysed. From 2010 to 2014, in total 477 patients were treated with IVT which included 12 VMIS (2.5%) patients. No complication or intracerebral haemorrhage occurred in the VMIS group. Median Rankin scale among VIMS patients improved from 4 at admission to 0 at discharge. Main symptoms of verified VMIS patients comprised mild aphasia/dysarthria (n=3) and gait ataxia (n=7), the latter not being registered by NIHSS. This data add evidence that IVT may be safely performed in VMIS. VMIS incorporates often gait ataxia resulting from brainstem stroke which is not tested using the NIHSS. Thrombolysis decision should also be based on functional disability. Data of all consecutive stroke patients with IVT admitted to the stroke unit at Klinikum Traunstein, Bavaria, Germany during the period 2010 to 2014 were prospectively recorded at the time of admission of patients. Klinikum Traunstein is a community hospital in a rural area of southeast Bavaria and takes care for approximately 200,000 people. Being a cohort study using a regularly approved therapy and performing all procedures in accordance with institutional guidelines, no specific approval by local ethics committee was required. During the five-year-period 2010 to 2014, altogether 477 stroke patients received IVT which included 12 (2.5%) patients with VMIS. The yearly number of stroke patients with IVT rose from 64 in the year 2010 to 123 in 2014. With increasing number of thrombolysis patients, minimum and maximum NIHSS of stroke patients changed from 1 (in 2010) to 0 (in 2014) and from 25 (in 2010) to 30 (in 2014), correspondingly.

With Regards,
Sara Giselle
Associate ManagingEditor
Journal of Stroke Research & Therapy