Ultrasonic sonothrombolysis systems to produce two acoustic pressure levels of insonation during stroke therapy, mid/high acoustic pressure insonation directed to the site of a blood clot where microbubbles are present to induce microbubble-mediated blood clot lysis, and low acoustic insonation directed to the region surrounding the site of the blood clot where microbubbles are present to stimulate microvascular reperfusion of the surrounding tissue. The systems simultaneously produce blood clot lysis at the site of an occlusion and stimulate reperfusion of tissue affected by the occlusion.