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  1. Tom Hughes
  1. Correspondence to Dr Tom Hughes, Department of Neurology, University Hospital of Wales, Cardiff, UK; tom.hughes2{at}

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Anyone who has faced the awkwardness of setting up a thrombolysis service will empathise with the determination and tenacity of the author of this paper; it was a heroic effort and, through example, he has set a potentially helpful precedent. However, having read three drafts, I am still not convinced that thrombolysis was appropriate in this case, for the following reasons.

Even the most evangelical thrombolyser might question stroke thrombolysis using a cardiac thrombolytic agent—unlicensed for cerebrovascular disease—in a unit without an established thrombolysis service: the poststroke care, …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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