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September 2009

Thrombolysis in Acute Ischemic Stroke With Vitreous Hemorrhage

Arch Neurol. 2009;66(9):1178-1179. doi:10.1001/archneurol.2009.184

The article by Ahmad and colleagues1 is of great interest. The authors describe a 70-year-old man presenting to the hospital with an acute ischemic infarction. Systemic thrombolysis was withheld because of the vitreous hemorrhage. I, however, respectfully disagree with their decision. This patient had a major stroke that affected the dominant cerebral hemisphere. If left untreated, he would have devastating neurological sequela and, if treated with thrombolytics, it may have worsened the vitreous hemorrhage.

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