Ischemic stroke treatment begins with first restoring a patient’s breathing, heart rate, and blood pressure back to normal ranges. Once that is accomplished, only then will a physician begin trying to reduce pressure in the brain.

Intravenous tissue plasminogen activator (tPA) and emergency IV medication is a therapy given intravenously that can break up a clot. An IV injection of recombinant tPA — also called alteplase (Activase®) — is often regarded as the best available treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm, ideally within the first 3 hours (but up to the first 4.5 hours) after stroke symptoms first began.

This drug restores blood flow by dissolving the blood clot causing a stroke. By quickly removing the cause of the stroke, tPA may help people recover more fully from a stroke. A physician will consider certain risks, such as potential bleeding in the brain, to determine whether tPA is appropriate for a patient having a stroke.