Counseling Patients on the Decision to Receive tPA for Acute Ischemic Stroke
   1)      To make your own wise decision, you must recognize that the facts
      are complicated and there are pros and cons.

   2)      There is a good chance that you will recover somewhat or even
      completely without treatment. There is also a possibility that
      the stroke can be fatal. We cannot predict how well you will do.

If we give this treatment to 100 people:
      3)      between 12 and 13 would be better off, recovering to a
      less severe degree of persistent disability than would have
      happened without treatment.

      4)      On the other hand, 87 to 88 of the 100 people who receive
      this treatment will not receive any benefit as a result of treatment.

      5)      About 6 of the 100 people will be much worse as a result
      of treatment and 3 of the 100 will die as a result of receiving
      the treatment.

      6)      Despite this risk, patients treated with this drug do not have
       a higher total death rate and 12 or 13 of the 100 will be better off
       as a result of treatment. Nevertheless, the few who have bleeding
       complications are definitely worse off.

     7)      With or without this treatment you will still continue to  receive all
      of our regular treatment.

     8)      The decision is entirely yours. If you choose the treatment,
      we must start right away. Any questions?

Source: Landau WM. Thrombolytic therapy in acute stroke. Arch Neurol
1998;55:1378.