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Shyam S. Moudgil, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

One of the 2 most important considerations in such a patient is the duration of the vitreous hemorrhage. A relatively older vitreous hemorrhage is less likely to rebleed. Second, preexisting visual and ocular status should be assessed. Presence of proliferative retinopathy may indicate poor vision at baseline. Knowledge of these 2 parameters would help in shared decision-making between the patient and physician. The patient should be educated about the risk of worsening . . . [Full Text of this Article]

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RELATED ARTICLE

Would You Perform Thrombolysis in This Acute Ischemic Stroke Patient?
Aftab Ahmad, Hock L. Teoh, and Vijay K. Sharma
Arch Neurol. 2009;66(3):410-411.
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RELATED LETTER

Thrombolysis in Acute Ischemic Stroke With Vitreous Hemorrhage—Reply
Aftab Ahmad, Hock L. Teoh, and Vijay K. Sharma
Arch Neurol. 2009;66(9):1178-1179.
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