Acute ischemic stroke (early management) ⭐
acute-ischemic-stroke · society: AHA/ASA · high-yield
Summary
The 2026 AHA/ASA guideline replaces the 2018 guideline and 2019 update for early management of acute ischemic stroke, spanning prehospital care through early in-hospital management. Major updates include endorsement of tenecteplase as equivalent to alteplase within 4.5 hours, expanded EVT eligibility (large cores, basilar occlusion to 24 h, selected pediatric patients), extended-window IVT (4.5–9 h with perfusion mismatch), abandonment of intensive glucose (80–130 mg/dL) and intensive post-EVT BP (<140 mm Hg) targets, mobile stroke unit endorsement, and first-time pediatric EVT/IVT recommendations.
Current guideline: 2026 AHA/ASA Early Management of AIS · 
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