The effectiveness of rt-PA in the elderly is an important but as yet incompletely resolved topic. In a recent paper in this journal,¹ Mouradian et al provide convincing data that patients older than 80 years who receive rt-PA are less likely to have a favourable outcome than their younger counterparts. This is in keeping with our own data showing that 5 of 24 patients (21%) treated with rt-PA aged 80 years or older were independent (mRS 0–2) after three months, compared with 39 of 77 patients …