Inclusion criteria
Clinical signs and symptoms of definite acute stroke
Clear time of onset
Presentation within 3 hrs of acute onset
Haemorrhage excluded by CT scan
Age 18 - 80 years old
NIHSS less than 25
Consent to treat (every effort must be made to contact next of kin)
Exclusion criteria
Rapidly improving or minor stroke symptoms
Stroke or serious head injury 3 months
Major surgery, obstetrical delivery, external heart massage last 14 days,
Seizure at onset of stroke
Prior stroke and concomitant diabetes
Severe haemorrhage last 21 days
Increase bleeding risk
History of central nervous damage (neoplasm, haemorrhage, aneurysm, spinal or intracranial surgery or haemorrhagic retinopathy)
Blood pressure above 185 mmHg systolic or 110 mmHg diastolic
Symptoms suggestive of SAH (even if CT is normal)
Known clotting disorder
Patient on heparin or warfarin
Suspected iron deficient anaemia or thrombocytopenia
Suspected hypoglycaemia or hyper glycaemia >3 mmol/l > 22 mmol/l
Bacterial endocarditis, pericarditis
Acute pancreatitis
Ulcerative GI disease last 3 months, oesophageal varices, arterial-aneurysm, arterial/venous malformation.
Severe liver disease including cirrhosis, acute hepatitis