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In practice, however, we are occasionally confronted with a patient whose medical history or comorbidities force us to make a decision without the support of guidelines. One such situation is the occurrence of acute ischemic stroke in a patient with known idiopathic thrombocytopenic purpura, where a tendency to use thrombolysis, anticoagulants, or antiplatelet agents collides with the fear of life-threatening bleeding. In this review, we try to outline current understanding of the pathophysiology of \u201cparadoxical\u201d ischemic events in this illness characterized by thrombocytopenia and to summarize clinical experience from case reports dealing with this topic, which could help us to rely on more than individual opinion seen through a purely \u201cneurological\u201d or \u201chematological\u201d prism.<\/jats:p>","DOI":"10.1177\/1076029614545213","type":"journal-article","created":{"date-parts":[[2014,8,13]],"date-time":"2014-08-13T09:37:44Z","timestamp":1407922664000},"page":"115-120","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["A Seeming Paradox"],"prefix":"10.1177","volume":"22","author":[{"given":"J\u00e1n","family":"Mihalov","sequence":"first","affiliation":[{"name":"Second Department of Neurology, Faculty of Medicine, Comenius University, Limbova, Bratislava, 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