The only current therapy for acute treatment of stroke that is widely available is TPA. TPA is also known as the clot busting drug and has been used for many years to dissolve clots associated with heart attacks. It has recently been demonstrated that when properly used, TPA can also dissolve the clots associated with strokes. In order for it to be used safely, TPA administration must start within 3 hours from the time of symptom onset. For this reason, any patient who begins to complain of sudden weakness, blindness, double vision, or difficulty with speech needs to be emergently evaluated in an emergency room. Even with proper use, the medication will cause a number of bleeds inside the brain, some of which will be fatal. Overall, the number of fatalities using this medication in controlled trials is no higher than in those patients who received placebo. On the other hand, the number of patients who recovered fully or almost fully was increased 30% with this medication.

In selected centers with neuroradiology capability, the delivery of medications like TPA delivered directly to the clot can safely be given for up to 6 hours.

Studies of other medications to protect the brain during an acute stroke have been disappointing. Since most patients do not arrive within even 6 hours of stroke, the number of strokes that can be treated with this therapy is very small.

Other treatment of stroke consists of prevention of complications of stroke like pneumonia. In addition, the rapid evaluation of the stroke patient for risk factors that would cause additional stroke may also prevent some strokes. Finally, identifying the proper forms of rehabilitation and providing the correct rehabilitation setting can help stroke patients recover more fully and live a more independent life.