To present a case of a patient with stroke symptoms receiving IV-tPA in the hyperacute period with pretreatment imaging evidence of an ischemic penumbra who subsequently had no evidence of infarction on post-thrombolysis imaging, and to explore the concept of aborted stroke following hyperacute IV thrombolysis throughout a systematic review of the literature. 

Some patients with imaging findings consistent with stroke, either restricted diffusion on diffusion-weighted imaging or presence of an ischemic core on CT perfusion, who are treated with thrombolysis, do not have evidence of infarction on post-treatment imaging. An overview of the frequency of such finding remains unknown. Although contradictory estimates have been published, it remains difficult to provide reliable findings given a considerable prevalence of stroke mimics. With the current use of mobile stroke treatment units (MSU) and faster thrombolysis, this question is especially salient.