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One of the issues that I faced recently when I was on call for thrombolysing stroke patients in Gwent, is that: seventy five years old woman was admitted within the thrombolysing time window after a collapse and left sided weakness. Her CT brain showed acute clot in the Rt MCA (Middle cerebral artery). I immediately thrombolysed the patient. Her CT scan which was requested as part of our 24hours follow up (Which we might not need but it was done any way) showed brain haemorrhage at the area of the infarction with slight mass effect. The question is whether this haemorrhage represents the transformation of the ischaemia or a true reaction to the thrombolysis? We know from experience that acute thrombus in the MCA make the area more vulnerable to bleed.