Tissue plasminogen activator for acute ischaemic stroke

To the Editor: The recent report on the use of a stroke thrombolysis protocol by Batmanian and colleagues1 raises many issues. The most recent guidelines regarding thrombolytic therapy for ischaemic stroke recommend that “If thrombolytic therapy is to be used . . . consultation with a neurologist or stroke physician is essential before instigating therapy. Strict adherence to the inclusion and exclusion criteria is important . . .”2 Hence, I find the integral role of a neurologist in Batmanian and colleagues’ protocol reassuring.