S01E22 Stroke Alert Teaching Rounds: What’s New in the 2026 AHA/ASA AIS Guideline

Stroke alert at 2 a.m. hits different—so in this episode we run “teaching rounds” on the AHA/ASA 2026 Guideline for the Early Management of Acute Ischemic Stroke, published in Stroke. We translate the biggest updates into what you actually do at the bedside: EMS prenotification and destination decisions, rapid imaging workflows (and what not to delay), IV thrombolysis decisions including tenecteplase vs alteplase within the 4.5-hour window, and how to think about disabling vs non-disabling symptoms when NIHSS looks “low.”Then we shift to endovascular therapy: what “expanded eligibility” means in practice, including selected patients with larger ischemic cores, and a clear stance on basilar artery occlusion thrombectomy in the appropriate window. Finally, we cover the underrated stuff that changes outcomes—glucose and blood pressure targets (including what to stop doing out of habit), plus early complications like dysphagia/aspiration risk.PubMed: https://pubmed.ncbi.nlm.nih.gov/41582814/Tags#Stroke #AcuteIschemicStroke #Neurology #EmergencyMedicine #CriticalCare #ICU #FOAMed #AHA #ASA #Guidelines #StrokeAlert #Thrombolysis #Tenecteplase #Alteplase #MechanicalThrombectomy #EndovascularTherapy #BasilarArteryOcclusion #LargeVesselOcclusion #NeurocriticalCare #EMS #Telestroke #CTAngiography #BPManagement #GlucoseControl #Dysphagia