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Sergio Calleja, MD; Sara Rodríguez, MD; Carlos H. Lahoz, MD

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

We were greatly interested in the article by Ozdemir et al¹ and also in the editorial comment by Caplan.² To add some arguments to the discussion, we describe a patient with fluctuating deficits successfully treated with recombinant tissue plasminogen activator (rtPA). A 26-year-old woman with a history of antiphospholipid syndrome was admitted to our hospital 1 hour after the onset of a left-sided hemiplegia and dysarthria. From the beginning she experienced uncountable (no less than 10) fluctuations, with a National Institutes of Health Stroke Scale score ranging from 0 to 10. The computed tomographic scan results were normal, whereas transcranial Doppler and computed tomographic angiography demonstrated a right middle cerebral artery (MCA) occlusion (Figure, A and B). When stroke workup was complete (150 minutes from stroke onset), the transcranial Doppler signal had not changed and fluctuations continued; thus, . . . [Full Text of this Article]

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