Patient description: The patient is a 63-year-old man presenting to the Emergency Department with a history of acute urinary retention in the past 2 days. Abdominopelvic CT scan revealed a large prostate and a bladder filled with urine. He is a candidate for urethral catheterization and TURP. Further evaluation revealed: Post-void residual: 71 mL Prostate volume (TRUS): 63 mL Prostate-specific antigen (PSA) level: 3.5 ng/mL His recent blood chemistry (3 days ago) was normal: Hgb: 13.6 g/dl WBC: 133000 /mm3 Plt: 370000 /ml PT: 12 second PTT: 34 second INR: 0.9 Creatinine: 0.5 mg/dl BUN: 10 mg/dl U/A: Color: yellow Appearance: cloudy PH: 5.3 Specific gravity: 1.010 Glc: 100 Nitrite: negative Ketone: none Leukocyte esterase: negative RBC: negative WBC: 2 WBCs/hpf U/C: negative

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Acute Ischemic Stroke Adult male or female patients ≥ 18 years (i.e., at least 18 years old at time of randomization). Extreme caution should be exercised in patients over 80 years of age with regards their general health, neurological status and any concomitant diseases and treatments that are likely to be more common; 2. Patients who have given written consent, legal representative consent or emergency consent (including e-consent) in accordance with local legal and IECs/IRBs requirements; 3. Patients presenting with an acute disabling ischemic stroke in either the anterior or posterior circulation.The time of onset is known or if unknown, the last time the patient was seen well, was at most 4.5 hrs before confirmation of the diagnosis enabling the initiation of alteplase administration within this time-frame; 4. Patients presenting at least a NIHSS ≥ 6 prior to thrombolysis with tPA; 5. Patients eligible for, or administered thrombolysis treatment with tPA; 6. Patients who can undergo mechanical thrombectomy if eligible; 7. Patients affiliated to social security insurance (if applicable, in accordance to local regulations); 8. Effective birth control method should be used for at least the next 2 months by women, and 4 months by men after IMP administration; birth control methods considered to be highly effective intrauterine device intrauterine hormone-releasing system bilateral tubal occlusion vasectomized partner sexual abstinence (if applicable in accordance to local regulations) 9. Women of child-bearing potential must undergo a urinary or plasma pregnancy test with negative results  Coma, and/or NIHSS >25; 2. Patients < 18 years of age; 3. Prior ischemic stroke within the past 3 months with pre-stroke mRS known to be > 2; 4. Baseline CT-scan evaluation: more than 1/3 of the middle cerebral artery) regions of clear hypodensity on the baseline imaging; 5. Significant mass effect with midline shift; 6. Stroke of hemorrhagic origin; 7. Contra-indications to thrombolysis with tPA: 1. Patients with known hypersensitivity to the active substance alteplase or to any of its excipients; 2. Patients with a high risk of hemorrhages significant bleeding disorder at present or within the past 6 months known haemorrhagic diathesis (episodes within past 6 months) patients receiving effective oral anticoagulant treatment, e.g. warfarin sodium manifest or recent severe or dangerous bleeding known history of or suspected intra-cranial haemorrhage any history of central nervous system lesion (i.e. trauma, intra-parenchymal neoplasm, unsecured aneurysm, intracranial or spinal surgery, vascular malformation etc..) recent (< 10 days) traumatic external heart massage, obstetrical delivery, or puncture of a non-compressible blood-vessel (e.g. subclavian or jugular vein puncture) bacterial endocarditis, pericarditis acute pancreatitis