Clinical Research Directory

Inclusion Criteria: * Acute ischemic stroke \< 72 h in a perforating artery territory on brain MRI * Early neurological deterioration or fluctuation, attested by the neurologist in charge, defined by a ≥ 3-point increase in global NIHSS score OR a 2-point increase on motor or ataxia score, whether this deterioration is transient or permanent. * Time between early neurological deterioration and randomization \< 6 hours * Age ≥ 18 years * Contraception required in women of childbearing potential (Intra-uterine device, hormonal contraception associated with inhibition of ovulation (combined or progestogen-only; oral, intravaginal or transdermal), Female Sterilization, Vasectomised partner, sexual abstinence) * Beneficiary of a health insurance system Exclusion Criteria: * \- Pre-Stroke Modified Rankin Score \> 3 * Contraindication to brain Magnetic Resonance Imaging (MRI) * High risk of intracerebral hemorrhage: * Cerebral microbleeds ≥ 10 * Non traumatic focal superficial siderosis * Hemorrhagic transformation of the present ischemic stroke * Previous history of intracerebral hemorrhage (symptomatic or asymptomatic identified on brain MRI) * Intracranial vascular malformation or tumor with suspected risk of rupture or bleeding * Prior intravenous thrombolysis \< 24 hours * Requirement for anticoagulation in the first 7 days after randomization * Systolic blood pressure (SBP) \> 180mmHG and/or mean arterial pressure (MAP) ≥ 110mmHG at inclusion * Large artery atherosclerosis (ipsilateral atherosclerotic stenosis \> 50%), intra and extracranial dissection, or cardio-embolic stroke mechanisms * Drugs with important interactions with norepinephrine: monoamine oxidase inhibitors (including reversible, non-selective agents such as linezolid), tricyclic antidepressants, entacapone. * Pregnancy or breastfeeding