Thrombolytic Therapy (Tissue Plasminogen Activator - TPA)

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Stroke

Close to 80% of all strokes are ischemic strokes, caused when blood clots form in one place in the body and travel to a smaller blood vessel in the brain, blocking the blood flow to that area.

For strokes of this nature, tPA can help dissolve the clot quickly. Often, tPA can limit the amount of permanent disability that can result from an ischemic stroke, especially if given within 3 hours of the initial symptoms of the stroke.

The decision to administer the drug is based upon the history, physical exam consistent with a significant stroke, and a brain CT scan to exclude bleeding.

If someone is having a hemorrhagic stroke or a stroke caused by bleeding in the brain, tPA is not given because this could worsen the stroke by causing increased bleeding.

Ischemic strokes often occur when a person is at rest or not under physical duress. Hemorrhagic strokes often occur during some sort of physical exertion. In some cases, the diagnosis of the actual type of stroke may be difficult and the risk of bleeding from tPA is a concern. Generally, the benefits of receiving it outweigh the risks if given in a timely manner.