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In reply

In response to the letter by Dr Rincon regarding our article,¹ it appears that he is addressing the issue of detection of acute ischemic stroke with various MR imaging sequences, whereas our study evaluated the diagnosis of intracerebral hemorrhage in the setting of acute stroke. We thus fail to see what "may be misleading" about our article. Our report illustrated the potential fallacies in relying exclusively on CT for ruling out hemorrhage in the process of evaluating a patient with acute stroke for eligibility for thrombolysis or anticoagulation. No portion of our case presentation or discussion addressed the issue of MR imaging in the diagnosis of acute ischemic stroke.

On the other hand, his statement "Moreover, no data support the benefit of heparin, low-molecular-weight heparin, or warfarin administration in the event of acute ischemic stroke" does not contradict any portion of our article. We stated, "Intravenous tissue plasminogen . . . [Full Text of this Article]

Carlos S. Kase, MD; Glenn D. Barest, MD
Boston, Mass

RELATED ARTICLE

Anticoagulation and Thrombolysis for Acute Ischemic Stroke and the Role of Diagnostic Magnetic Resonance Imaging
Fred Rincon
Arch Neurol. 2004;61(5):801-802.
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