The major issue of contention is fear of conversion of pure ischemic stroke into hemorrhagic stroke .
But here is a catch if you worry about that . . . who will worry about recurrent emboli from heart ?
I think the 2007 stroke guidelines are the latest .Even after going through the guidelines I am not really clear about the answer for the question posed in this article.
One more thing I (mis) understood was , In acute stroke thrombolysis seems to be safe . . . Heparin seems to be dangerous ? Is that true ? It defies logic for me !
One possible explanation is thromolysis is a emergency single shot salvaging process . While prolonged heparin will ooze blood into Infarct ! This is exactly is the reason in tPA should not be followed up with heparin in acute strokes.(unlike STEMI where a follow up heparin is a must )
Regarding prevention of recurrent emboli , we need to bother about whether it is predominately platelet rich or RBC rich
Readers may contribute to find the exact answer !