The authors present an overview of the current evidence and management recommendations for evaluation and treatment of adults with acuteischemicstroke. The intended audiences are prehospital care providers, physicians, allied healthprofessionals, and hospital administrators responsible for the care of acuteischemicstrokepatients within the first 48 hours from stroke onset. These guidelines supersede the prior 2007 guidelines and 2009 updates.

Members of the writing committee were appointed by the AmericanStrokeAssociationStroke Council's Scientific Statement Oversight Committee, representing various areas of medical expertise. Strict adherence to the American Heart Association conflict of interest policy was maintained throughout the consensus process. Panel members were assigned topics relevant to their areas of expertise, reviewed the stroke literature with emphasis on publications since the prior guidelines, and drafted recommendations in accordance with the American Heart AssociationStroke Council's Level of Evidence grading algorithm.

The goal of these guidelines is to limit the morbidity and mortality associated with stroke. The guidelines support the overarching concept of stroke systems of care and detail aspects of stroke care from patient recognition; emergency medical services activation, transport, and triage; through the initial hours in the emergency department and stroke unit. The guideline discusses earlystroke evaluation and general medical care, as well as ischemicstroke, specific interventions such as reperfusion strategies, and general physiological optimization for cerebral resuscitation.

Because many of the recommendations are based on limited data, additional research on treatment of acuteischemicstroke remains urgently needed.