tPA (alteplase) for ischemic strokes in patients on oral antithrombotics (warfarin, etc)

We're getting questions about when to use tPA (alteplase) for ischemic strokes in patients on oral antithrombotics (warfarin, etc).

With stroke, "time is brain."

Giving tPA within 3 hours of stroke symptoms can increase the chance of a good recovery and reduce disability. Some patients also benefit when it's given up to 4.5 hours from the start of symptoms.