A patient experiencing an ischemic stroke receives tPA, but despite initial reperfusion, neurological deficits worsen. Which process is most likely contributing to this paradoxical decline?

💡 Explanation

Hemorrhagic transformation, where ischemic tissue bleeds after reperfusion, explains the worsened deficits because tPA, while dissolving the clot, can exacerbate bleeding into the damaged penumbra. This causes secondary injury, therefore choice D is correct rather than the others which represent potential, but less likely, consequences.

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