Management of Acute Ischemic Stroke

Current Standard of Care

The American College of Chest Physicians recommends antiplatelet therapy for secondary prevention of ischemic stroke, including aspirin (80-325mg daily), clopidogrel (75mg daily), or combined aspirin/extended-release dipyridamole 1, 2, 3
For acute ischemic stroke, guidelines recommend IV recombinant tissue plasminogen activator (r-tPA) within 3-4.5 hours of symptom onset 2
Early aspirin therapy (160-325mg) is recommended within 48 hours of stroke onset 2
For minor ischemic stroke or high-risk TIA, loading doses of antiplatelet agents are recommended (aspirin 160-325mg and clopidogrel 300-600mg) 5

Current stroke guidelines do not recommend piracetam as a primary treatment for acute stroke, as it is not included in current stroke management guidelines 1, 2, 3
Delaying administration of proven therapies like r-tPA or antiplatelet agents while considering piracetam is not recommended 2