Neurology Emergency Medicine Strong — Strbian 2012 / NICE NG128

SEDAN Score for Post-tPA Haemorrhage

Predicts risk of symptomatic intracranial haemorrhage (sICH) after IV thrombolysis (rtPA) for ischaemic stroke.

Score interpretation

Low sICH Risk (SEDAN 0–1) 0–1

Symptomatic ICH after IV thrombolysis 1.4 % (score 0) and 2.9 % (score 1) in the derivation cohort; 1.0 % and 3.5 % on validation.

→ Standard post-thrombolysis care and monitoring per the local stroke protocol.

Intermediate sICH Risk (SEDAN 2–3) 2–3

Symptomatic ICH 8.5 % (score 2) and 12.2 % (score 3) in derivation; 5.1 % and 9.2 % on validation.

→ Include the bleeding risk in the consent discussion; meticulous blood pressure control and neurological observations after thrombolysis.

High sICH Risk (SEDAN ≥ 4) 4–6

Symptomatic ICH 21.7 % (score 4) and 33.3 % (score 5) in derivation; 16.9 % and 27.8 % on validation (score 6 not reported).

→ Senior stroke physician review of risk and benefit — the score informs, but does not replace, the treatment decision. Urgent CT head if neurological deterioration after thrombolysis.

Interpretation bands for the SEDAN Score. Apply clinical judgement and local guidance.

References

Strbian D, et al. Symptomatic intracranial hemorrhage after stroke thrombolysis: the SEDAN score. Ann Neurol. 2012;71(5):634–641.
NICE NG128. Stroke and transient ischaemic attack in over 16s: diagnosis and initial management. 2019.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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