The risk of hemorrhage after tissue plasminogen activator (tPA) administration in the treatment of acute ischemic stroke is well known, with intracranial hemorrhage the primary concern.1 Tissue plasminogen activator has also been known to cause airway compromise due to angioedema, occurring in 1.3–5.1% of patients.2,3 While rare, there have also been reported cases of tPA administration leading to hemorrhage causing airway compromise through lingual hematoma and thyroid hemorrhage.4–6. The gene discussed is PLAT; the disease is intracranial hemorrhage.