The use of intravenous tPA within 3 hours after acute ischemic stroke
has been proved to increase the number of good outcomes. However, tPA
is a toxic therapy that carries a substantial risk of intracerebral he
morrhage. To decrease the risk, tPA use must be restricted to a carefu
lly selected patient population. Treatment must be administered in an
intensive care setting and directed by physicians with expertise in di
agnosing and managing stroke.