What is the main contraindication for administering thrombolytics in ischemic stroke?"

The main contraindication for administering thrombolytics in ischemic stroke is blood pressure that exceeds 185/110 mmHg. Elevated blood pressure poses a significant risk when using thrombolytics because the medications can increase the likelihood of hemorrhagic transformation of the stroke or other potentially life-threatening bleeding complications. When the blood pressure is too high, it raises the risk of causing bleeding in the brain or exacerbating existing hemorrhages, which would negate the benefits of clot dissolution in a stroke patient.

Other factors, while they may warrant caution, do not carry the same level of severity. For instance, recent minor surgery or severe headache might suggest concerns, but they do not represent absolute contraindications when evaluated in the overall context of the patient's condition. Likewise, chest pain could indicate other issues, but it doesn't restrict the use of thrombolytics unless tied to other complicating factors. Thus, maintaining blood pressure within a safe range is crucial when considering thrombolytic therapy in the treatment of ischemic stroke.