Latest Research from Stroke Journals

Critical Care Emergency Medicine Neurology Pharmacy/Pharmacology Stroke

Slow and Steady – Be Careful with ICH BP Control
January 15, 2026January 17, 2026

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In this retrospective multicenter study, both early, overly rapid systolic blood pressure (SBP) reduction after intracerebral hemorrhage (ICH) and overshooting SBP targets (<120 mmHg) were linked with worse functional outcomes at discharge.

Source
Early Intensive Blood Pressure Reduction After Intracerebral Hemorrhage Is Associated With Worse Functional Outcome: The Risk of Overshooting Blood Pressure Goals. Ann Emerg Med. 2025 Dec 9:S0196-0644(25)01303-4. doi: 10.1016/j.annemergmed.2025.10.009. Epub ahead of print. PMID: 41369631; PMCID: PMC12757810.

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Emergency Medicine EMS Neurology Stroke

What Are the Best LVO Stroke Predictors for EMS?
December 5, 2025December 6, 2025

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The prehospital screening tools for large vessel occlusion (LVO) with the best accuracy were: FAST-ED, RACE, and LAMS. Cincinnati Prehospital Stroke Scale (CPSS) was the worst.

Source
Accuracy of Published Screening Tools for Large Vessel Occlusion in Patients With Suspected Acute Ischemic Stroke: A Prospective Cohort Study. Ann Emerg Med. 2025 Sep 19:S0196-0644(25)01092-3. doi: 10.1016/j.annemergmed.2025.07.030. Epub ahead of print. PMID: 40974366.

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Emergency Medicine Neurology Pharmacy/Pharmacology Stroke

TNK 4.5 to 24 Hours After Stroke – Better Late Than Never?
December 4, 2025December 6, 2025

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Patients with delayed presentation, 4.5 to 24 hours after onset of ischemic stroke, still had significant benefit from tenecteplase (TNK): NNT = 17, NNH = 72.

Source
Tenecteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: A Meta-Analysis of Randomized Controlled Trials. Stroke. 2025 Oct 13. doi: 10.1161/STROKEAHA.125.053256. Epub ahead of print. PMID: 41078125.

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Emergency Medicine Neurology Pharmacy/Pharmacology Stroke

A New HOPE | 24-hour Lytic Window for Stroke?
September 19, 2025September 22, 2025

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IV alteplase administered between 4.5 to 24 hours in patients with acute ischemic stroke and salvageable brain tissue on perfusion imaging had significantly improved functional outcomes but increased incidence in symptomatic intracranial hemorrhage.

Source
HOPE investigators. Alteplase for Acute Ischemic Stroke at 4.5 to 24 Hours: The HOPE Randomized Clinical Trial. JAMA. 2025 Sep 2;334(9):788-797. doi: 10.1001/jama.2025.12063. PMID: 40773205; PMCID: PMC12332759.

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Emergency Medicine Neurology Neurosurgery Stroke

Thrombectomy in Large-Core Infarcts?
August 29, 2025September 6, 2025

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This pooled appraisal supports the potential efficacy and expanded role of endovascular therapy (EVT) in a broader stroke population than once thought, particularly those patients with large core infarcts across a wider treatment window.

Source
Mechanical Thrombectomy for Large Ischemic Stroke: A Critical Appraisal of Evidence From 6 Randomized Controlled Trials. Stroke. 2025 Jul;56(7):1917-1927. doi: 10.1161/STROKEAHA.125.050402. Epub 2025 May 20. PMID: 40391430

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Critical Care Emergency Medicine Stroke

Break the Enchantment – Intensive BP Control and Brain Swelling
August 1, 2025July 29, 2025

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Intensive blood pressure lowering after thrombolysis in acute ischemic stroke did not significantly reduce brain swelling compared to standard BP management.

Source
Effects of Intensive Blood Pressure Lowering on Brain Swelling in Thrombolyzed Acute Ischemic Stroke: The ENCHANTED Results. Stroke. 2025 Jun;56(6):1388-1395. doi: 10.1161/STROKEAHA.124.049938. Epub 2025 Apr 3. PMID: 40177745

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Cardiology Family Medicine Hematology/Oncology Internal Medicine Pharmacy/Pharmacology Stroke

Risk of ICH with Apixaban vs. Aspirin to Prevent Stroke
July 24, 2025July 22, 2025

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In RCTs comparing aspirin with apixaban for ischemic stroke prevention, apixaban was associated with a nonsignificantly lower risk of intracranial hemorrhage.

Source
Risk of Intracranial Hemorrhage With Apixaban Versus Aspirin Therapy: A Meta-Analysis of Randomized Controlled Trials. Stroke. 2025 Jun 4. doi: 10.1161/STROKEAHA.125.051088. Epub ahead of print. PMID: 40464082.

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Emergency Medicine Neurology Pharmacy/Pharmacology Stroke

BRIDGE-TNK RCT – Tenecteplase + Thrombectomy for LVO?
July 24, 2025July 24, 2025

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Tenecteplase before thrombectomy in adults with large vessel occlusion (LVO) stroke resulted in better 90-day functional outcomes than thrombectomy alone.

Source
BRIDGE-TNK Trial Investigators. Intravenous Tenecteplase before Thrombectomy in Stroke. N Engl J Med. 2025 Jul 10;393(2):139-150. doi: 10.1056/NEJMoa2503867. Epub 2025 May 21. PMID: 40396577.

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Emergency Medicine Neurology Stroke

What’s the Long-Term Stroke Risk in TIA Patients?
July 1, 2025June 29, 2025

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Patients with transient ischemic attack (TIA) or minor stroke remain at high risk of subsequent stroke for up to 10 years, emphasizing the need for sustained secondary prevention beyond the initial acute period.

Source
Long-Term Risk of Stroke After Transient Ischemic Attack or Minor Stroke: A Systematic Review and Meta-Analysis. JAMA. 2025 May 6;333(17):1508-1519. doi: 10.1001/jama.2025.2033. PMID: 40136306

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Internal Medicine Neurology Pharmacy/Pharmacology Stroke

Alteplase for Posterior Stroke at 4.5 to 24 Hours
June 4, 2025June 8, 2025

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For select patients with posterior ischemic stroke, late alteplase administration between 4.5-24 hours after symptom onset resulted in improved functional independence at 90 days.

Source
Alteplase for Posterior Circulation Ischemic Stroke at 4.5 to 24 Hours. N Engl J Med. 2025 Apr 3;392(13):1288-1296. doi: 10.1056/NEJMoa2413344. PMID: 40174223

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