After thrombolytic therapy, what neurological changes would indicate the need for immediate intervention?

Severe headache or confusion after thrombolytic therapy can be indicative of several critical issues, including the possibility of intracranial hemorrhage or other complications related to the therapy. Thrombolytic agents are designed to dissolve blood clots that may be causing an ischemic stroke, but they also carry risks, including bleeding. A sudden onset of a severe headache, often described as the worst headache ever experienced, along with confusion, may suggest that a bleed has occurred or that there is some other emergent change in the patient’s neurological status. Therefore, these symptoms warrant immediate medical evaluation and intervention to assess for potential complications and to initiate appropriate treatment if necessary.

Other changes like a slight decrease in alertness can often be monitored and may not indicate a severe issue immediately. Sudden changes in emotional status can be concerning but are not as specific as severe headache or confusion for indicating a critical intervention need. Lastly, improvement of motor functions would generally be seen as a positive sign, reflecting the effectiveness of the treatment rather than a cause for alarm. Therefore, the presence of severe headache or confusion is the most critical scenario that demands urgent assessment and intervention.