Acute ischaemic stroke in patients aged 80 years and older: focus on the tolerability of thrombolytic agents.

Ischaemic stroke is a devastating disease in the elderly with 30-50% 90-day mortality. Thrombolysis for stroke is potentially life saving and disability sparing in this group but the number of elderly patients studied in clinical trials, particularly those aged > or = 80 years, has been small. Indeed, < 50 patients aged > 80 years have been treated in clinical thrombolytic trials of ischaemic stroke. However, there is no evidence of a differential treatment effect by age. Multiple cohort studies have suggested that the risk of symptomatic intracerebral haemorrhage among octogenarians is no different from that in younger patients. Thrombolysis can be safely offered to acute ischaemic stroke patients aged > or = 80 years, although robust data from randomized clinical trials are relatively scarce.