Tschirret O, et al. - This study examined if brain atrophy affected the risk of early neurological deterioration (END) and the outcome in severe ischemic strokes after intravenous (IV) thrombolysis. Researchers studied 137 patients who had a National Institutes of Health Stroke Scale (NIHSS) ≥15, MRI at admission, and IV thrombolysis. END and a good outcome were reported in 20 (14.6%) and 48 (37.5%) patients, respectively. In univariate analysis, predictors of END included age, diabetes and parenchymal hemorrhage, with only age being linked to END after multivariate analysis. No impact of brain atrophy was seen on the risk of END and the outcome at 3 months in severe ischemic strokes after IV thrombolysis.