Skip to content

Stroke guidelines

TL;DR — Stroke guidance is a portfolio, not one document: acute ischemic stroke, intracerebral hemorrhage (ICH), aneurysmal subarachnoid hemorrhage (aSAH), secondary prevention, rehabilitation and systems of care each have separate recommendations. As of August 2026, the AHA/ASA has current 2026 guidelines for both acute ischemic stroke and adult stroke rehabilitation/recovery; these replace the 2018/2019 acute documents and the 2016 rehabilitation guideline, respectively (Prabhakaran 2026, PMID 41582814; Richards 2026, PMID 42657476). Major families agree on organized stroke-unit care, urgent brain imaging, time-dependent reperfusion, mechanism-specific prevention and interdisciplinary rehabilitation, but diverge where evidence is indirect: tenecteplase regimens, mild or distal occlusion thrombectomy, large-core selection, antithrombotic timing after hemorrhage, and procedure choice for some aneurysms. AHA/ASA uses class-of-recommendation/level-of-evidence language; ESO predominantly uses GRADE and explicitly labels expert consensus when evidence is inadequate (Berge 2021, PMID 33817340; Turc 2019, PMID 31165090). Recommendations must be interpreted with publication cutoff, corrigenda, local licensing, capability and patient values—not copied as timeless treatment rules.

Current major guideline map

Clinical domain United States Europe Canada / other implementable frameworks
Acute ischemic stroke AHA/ASA 2026 (replaces 2018 + 2019 update) (Prabhakaran 2026, PMID 41582814) ESO IV thrombolysis 2021; ESO–ESMINT thrombectomy 2019 (Berge 2021, PMID 33817340; Turc 2019, PMID 31165090) Canadian acute management 2022 update (Heran 2024, PMID 36529857); NICE NG128 updated 2022; Australian living guideline
Secondary prevention AHA/ASA 2021 (Kleindorfer 2021, PMID 34024117) ESO topic guidelines: AF, carotid stenosis, dissection, PFO, covert small-vessel disease (Klijn 2019, PMID 31984228; Bonati 2021, PMID 34414303; Debette 2021, PMID 34746432; Caso 2024, PMID 38752755; Wardlaw 2021, PMID 34414301) Canadian secondary prevention 2020 update (Gladstone 2022, PMID 34140063)
Spontaneous ICH AHA/ASA 2022 (Greenberg 2022, PMID 35579034) ESO–EANS 2025, replacing ESO 2014 (Steiner 2025, PMID 40401775; Steiner 2014, PMID 25156220) Canadian ICH 2020 update (Shoamanesh 2021, PMID 33174815)
Aneurysmal SAH AHA/ASA 2023 (Hoh 2023, PMID 37212182) ESO–EANS–ESMINT 2026, replacing ESO 2013 (Vergouwen 2026, PMID 42095754; Steiner 2013, PMID 23406828) National acute pathways commonly incorporate neurosurgical transfer and neurocritical care
Primary prevention AHA/ASA 2024 (Bushnell 2024, PMID 39429201) Risk-factor guidance distributed across cardiovascular and disease-specific documents Population implementation varies by health system
Rehabilitation / participation AHA/ASA adult rehabilitation/recovery 2026, replacing 2016 (Richards 2026, PMID 42657476) ESO produces topic guidance rather than one complete rehabilitation document Canadian rehabilitation/recovery 2019 update (Teasell 2020, PMID 31983296); Australian living guideline
Resource-stratified services — — WSO Global Stroke Services Guidelines and Action Plan tiers services by available resources (Lindsay 2014, PMID 25250836)

The registry behind this synthesis is in literature/guidelines/REGISTRY.md at condition level. “Current” there means not formally superseded by a newer document in the same lineage as of 2026-08-30; it does not mean every recommendation reflects evidence published after its search cutoff.

How recommendation language differs

Framework What a strong recommendation means What it does not mean
AHA/ASA Class 1 benefit greatly exceeds risk; procedure/treatment should be performed or administered that evidence must be randomized or high certainty; level of evidence is separate
AHA/ASA Class 2a benefit probably exceeds risk; reasonable universal standard or proof that every subgroup benefits
AHA/ASA Class 2b benefit is at least comparable to risk; may be reasonable equivalence to a Class 1 recommendation
AHA/ASA Class 3: no benefit / harm no demonstrated benefit, or risk exceeds benefit that the underlying question can never change with new trials
ESO GRADE strong panel judges desirable effects outweigh undesirable effects for most patients necessarily high-certainty evidence; certainty is reported separately
ESO weak / conditional preferred option depends on patient values, context or uncertain evidence “do nothing” or clinical irrelevance
ESO expert consensus insufficient evidence for a GRADE recommendation, but panel provides practice guidance trial-derived efficacy

ESO’s thrombolysis and thrombectomy documents describe explicit question formulation, systematic review, evidence grading and consensus statements where evidence is insufficient (Berge 2021, PMID 33817340; Turc 2019, PMID 31165090). The AHA/ASA 2026 ischemic guideline searched literature principally from the prior guideline through December 2024 and added selected studies through March 2025; publication in 2026 therefore does not imply inclusion of every 2025–2026 trial (Prabhakaran 2026, PMID 41582814).

Acute ischemic stroke: the shared core

Across major families, the shared sequence is emergency recognition, immediate noncontrast brain imaging, vascular imaging when LVO is suspected, intravenous thrombolysis for eligible patients without avoidable delay, thrombectomy for eligible occlusions, and stroke-unit admission. ESO found high-certainty evidence for alteplase within 4.5 hours and for selected wake-up stroke with MRI DWI–FLAIR mismatch when thrombectomy is not planned (Berge 2021, PMID 33817340). ESO–ESMINT found high-certainty evidence for thrombectomy plus best medical management within 6 hours and moderate-certainty evidence from 6–24 hours in patients meeting the selection criteria of the pivotal trials (Turc 2019, PMID 31165090).

The 2026 AHA/ASA update explicitly replaces both the 2018 guideline and its 2019 update. Its stated update domains include thrombolytic choice and eligibility, thrombectomy selection, hyperglycemia, dysphagia, pediatric stroke and modification of thrombolysis contraindications (Prabhakaran 2026, PMID 41582814). Therefore, recommendation tables copied from Powers 2019 should be treated as historical unless reconciled against the replacement (Powers 2019, PMID 31662037).

Decision Broad agreement Residual disagreement / implementation variation
Do not delay eligible IV thrombolysis for a possible thrombectomy IV thrombolysis remains part of best medical therapy when indicated (Turc 2019, PMID 31165090) drug choice, dose and how to treat some directly presenting LVO subgroups have changed as evidence evolved
Wake-up / unknown-onset stroke advanced-imaging selection can identify candidates (Berge 2021, PMID 33817340) MRI mismatch versus perfusion pathways depend on access and protocol
EVT within 6 hours standard for eligible anterior-circulation LVO occlusion site, disability, age and infarct extent still require individualized interpretation
EVT 6–24 hours recommended for trial-matched selected patients (Turc 2019, PMID 31165090) criteria broaden as large-core and other trials enter newer guidance
Bridging thrombolysis major guidelines retain IV thrombolysis when otherwise indicated direct-EVT evidence and tenecteplase practice produce regional variation
Tenecteplase incorporated into newer North American guidance and Canadian update (Prabhakaran 2026, PMID 41582814; Heran 2024, PMID 36529857) licensing, dose, target population and wording differ across jurisdictions
Mild or improving deficit disability, not NIHSS alone, drives treatment relevance “nondisabling” remains judgment-dependent
Direct-to-thrombectomy-center routing may reduce secondary-transfer delay must be balanced against thrombolysis delay and false-positive bypass

The practical lesson is to record the exact edition and recommendation version in protocols. A 2026 order set citing “AHA/ASA 2019” for thrombolysis or thrombectomy selection is a version-control failure even when much of the underlying practice remains correct.

Intracerebral hemorrhage

AHA/ASA 2022 and ESO–EANS 2025 both organize care around immediate diagnosis, blood-pressure management, rapid reversal of anticoagulation, neurocritical monitoring, selected surgery and structured recovery (Greenberg 2022, PMID 35579034; Steiner 2025, PMID 40401775). The new European document supersedes the 2014 ESO guideline, which should remain discoverable only for historical comparison (Steiner 2014, PMID 25156220).

Topic Stable direction Why wording varies
Anticoagulant reversal reverse urgently with agent matched to anticoagulant comparative evidence and drug availability differ; ESO issued a dedicated reversal guideline (Christensen 2019, PMID 31903428)
Acute blood pressure smooth, sustained lowering is favored over large variability target, eligible severity and treatment window depend on trial population; ESO issued a 2025 BP update published in 2026 (Sandset 2026, PMID 42095756)
Platelet transfusion not a routine response to antiplatelet-associated spontaneous ICH neurosurgical context and thrombocytopenia are different questions
Craniotomy / minimally invasive surgery selected patients may benefit; routine universal surgery is unsupported location, volume, consciousness, timing and technique change risk–benefit
Prognostic scores useful for communication and stratification should not be the sole basis for early treatment limitation
Restarting antithrombotics individualized balance of thromboembolism and recurrent ICH timing and high-risk imaging phenotypes remain evidence gaps

Canadian recommendations provide a system-oriented bridge from emergency care through secondary prevention and align reversal decisions with locally available agents (Shoamanesh 2021, PMID 33174815). Guideline disagreement here usually reflects low event counts, heterogeneous hematoma anatomy, evolving procedures and value judgments about disability—not merely different readings of one definitive trial.

Aneurysmal subarachnoid hemorrhage

The AHA/ASA 2023 guideline replaced its 2012 predecessor and frames care as patient-centered prevention, diagnosis, aneurysm securing, complication management and recovery (Hoh 2023, PMID 37212182). The 2026 joint ESO–EANS–ESMINT guideline is the current European document and supersedes the 2013 ESO guideline (Vergouwen 2026, PMID 42095754; Steiner 2013, PMID 23406828).

Shared high-level priorities are rapid transfer to an experienced neurovascular center, early securing of the ruptured aneurysm, nimodipine, euvolemia, detection and treatment of delayed cerebral ischemia, and multidisciplinary neurocritical care. Procedure choice is anatomy- and expertise-dependent: a recommendation favoring endovascular treatment for a subgroup is not a claim that coiling is superior for every aneurysm. The date of aneurysm occlusion, use of antiplatelets for adjunctive devices, and management of delayed ischemia should be read from the current document rather than inherited protocol text.

Secondary prevention is mechanism-specific

AHA/ASA 2021 and Canadian 2020 recommendations converge on diagnostic classification, vascular-risk control, antithrombotic therapy matched to mechanism, lipid lowering, smoking cessation, physical activity and adherence (Kleindorfer 2021, PMID 34024117; Gladstone 2022, PMID 34140063). “Secondary prevention after stroke” is not synonymous with “give aspirin.”

Mechanism / phenotype Guideline direction Important boundary
Non-cardioembolic ischemic stroke/TIA antiplatelet therapy long-term dual antiplatelet therapy is not the default; short-course use is restricted to defined early high-risk presentations
Atrial fibrillation oral anticoagulation; ESO prefers a direct oral anticoagulant over vitamin K antagonist for eligible non-valvular AF initiation timing after acute infarct and restarting after prior ICH are less certain (Klijn 2019, PMID 31984228)
Symptomatic carotid stenosis timely endarterectomy for suitable patients; stenting for selected anatomy/risk age, stenosis degree, sex, delay and procedural risk matter (Bonati 2021, PMID 34414303)
Cervical artery dissection antithrombotic strategy and intervention individualized evidence does not support importing atherosclerotic algorithms unchanged (Debette 2021, PMID 34746432)
PFO-associated cryptogenic stroke closure for carefully selected patients after adequate causal workup age, shunt/anatomy, competing mechanisms and post-closure AF alter net benefit (Caso 2024, PMID 38752755)
Covert small-vessel disease without clinical stroke control hypertension; do not prescribe aspirin solely for covert lesions direct evidence is sparse; lifestyle advice often rests on general-health evidence (Wardlaw 2021, PMID 34414301)
Moyamoya angiopathy revascularization strategy depends on hemorrhagic/ischemic presentation and hemodynamic impairment much guidance is low-certainty or expert consensus (Bersano 2023, PMID 37021176)
Cerebral venous thrombosis acute parenteral anticoagulation; decompressive surgery for impending herniation the 2017 ESO document predates major later DOAC evidence and flags multiple unanswered questions (Ferro 2017, PMID 28833980)

The PFO example shows why headline summaries mislead. The 2024 ESO guideline is explicitly about PFO after stroke, not population screening or closure of incidental PFO (Caso 2024, PMID 38752755). Similarly, the covert-small-vessel-disease guideline recommends against aspirin for the imaging finding alone and notes little direct evidence across many interventions (Wardlaw 2021, PMID 34414301).

Rehabilitation, cognition and participation

The AHA/ASA 2026 adult rehabilitation guideline explicitly replaces its 2016 predecessor and updates assessment across the recovery continuum, medical comorbidity management, fracture and fall prevention, technology-enabled rehabilitation, caregiver support, participation, and return to work and driving (Richards 2026, PMID 42657476). Canadian recommendations remain unusually modular across rehabilitation/recovery and mood/cognition/fatigue: the rehabilitation update covers coordinated assessment, goal-oriented therapy and community participation, while the companion domain document covers mood, vascular cognitive impairment and fatigue (Teasell 2020, PMID 31983296; Lanctôt 2020, PMID 31221036). Across families, acute reperfusion statements often have more precise treatment windows and higher-certainty dose evidence than rehabilitation sequencing and equitable-access recommendations.

Australian guidance uses a living model, updating individual recommendations online as evidence changes (Stroke Foundation — “Living Clinical Guidelines for Stroke Management,” https://informme.org.au/guidelines/living-clinical-guidelines-for-stroke-management, accessed 2026-08-30). That model reduces edition lag but creates a citation problem: the access date and recommendation version must accompany any extract.

UK and resource-stratified guidance

NICE NG128 covers diagnosis and initial management of stroke and TIA in people over 16 and is maintained as an online recommendation set rather than a single PubMed-indexed journal article (NICE — “Stroke and transient ischaemic attack in over 16s: diagnosis and initial management,” https://www.nice.org.uk/guidance/ng128, accessed 2026-08-30). It should be paired with NICE rehabilitation guidance where the question extends beyond initial management. UK wording also operates inside NHS organization and technology appraisal decisions; it cannot be transplanted without checking local licensing and pathways.

The WSO action plan stratifies services by three resource levels and supplies a scaffold for developing stroke systems rather than pretending every setting can immediately reproduce a comprehensive center (Lindsay 2014, PMID 25250836). The Canadian acute document similarly addresses prehospital, emergency, imaging, thrombolysis, thrombectomy, inpatient complications, early rehabilitation, end-of-life care and virtual care as one connected system (Heran 2024, PMID 36529857). Resource-stratification is not permission for lower-quality care: it identifies the next achievable capability and the indicators needed to measure progress.

Where guidelines disagree—and why

Question Source of disagreement How to handle it
Alteplase vs tenecteplase rapidly changing trials, regulatory labels, dose/population differences, update date use the newest local guideline and record drug/dose/population exactly (Prabhakaran 2026, PMID 41582814; Berge 2021, PMID 33817340)
IV thrombolysis before EVT noninferiority margins and workflow differ across direct presenters and transfers do not generalize a direct-EVT trial beyond its pathway; retain IVT when guideline-eligible (Turc 2019, PMID 31165090)
Thrombectomy in large core, distal/medium occlusion or low NIHSS trial eligibility and device-era evidence evolve quickly a 2026 SVIN focused guideline does not support routine DMVO EVT, while considering EVT reasonable for selected disabling dominant-M2 occlusion; preserve that boundary (Majidi 2026, PMID 42404835)
Acute ICH BP target achieved BP, variability, severity, timing and safety differ across trials implement a smooth protocol and preserve subgroup boundaries (Greenberg 2022, PMID 35579034; Sandset 2026, PMID 42095756)
Surgery for ICH anatomy and procedure differ; neutral overall trials can contain plausible subgroups state technique, location, volume, timing and certainty (Steiner 2025, PMID 40401775)
Anticoagulation after ischemic stroke with AF early recurrence competes with hemorrhagic transformation distinguish choice of agent from timing (Klijn 2019, PMID 31984228)
Restart after ICH ischemic indication competes with hemorrhage recurrence phenotype shared decision and individualized imaging/etiology assessment
Carotid stenting vs endarterectomy age, anatomy, timing and operator outcomes modify risk use audited local peri-procedural complication rates (Bonati 2021, PMID 34414303)
PFO closure causal attribution and competing AF/atherosclerosis risk require complete workup and trial-matched selection (Caso 2024, PMID 38752755)

Three recurring causes explain most divergence. First, publication timing: AHA/ASA 2026 can incorporate evidence unavailable to ESO 2021. Second, framework: a GRADE panel may issue a conditional recommendation where a class/level framework uses “may be reasonable.” Third, implementation context: a recommendation assuming 24/7 perfusion imaging, thrombectomy and neurocritical care cannot define minimum care in a resource-limited district hospital.

A guideline-use checklist

  1. Name the clinical phenotype: ischemic stroke, TIA, ICH, aSAH, CVT or another cerebrovascular disorder.
  2. Identify the care phase: prehospital, hyperacute, inpatient, secondary prevention, rehabilitation or long-term participation.
  3. Use the newest unsuperseded document in that lineage; retain older documents only to explain historical change.
  4. Record publication year and evidence-search cutoff.
  5. Read class/strength and certainty/level separately.
  6. Confirm the patient matches the population, imaging, time window and treatment pathway behind the recommendation.
  7. Check corrigenda, focused updates, local drug/device approval and service capability.
  8. Where two guidelines disagree, compare their PICO question and evidence cutoff before comparing wording.
  9. Document patient values where the recommendation is conditional or alternatives carry different disability tradeoffs.
  10. Measure implementation with patient outcomes and equity, not recommendation adoption alone.

Evidence and coverage limits

  • Guideline recommendations are secondary syntheses; this page does not replace reading the recommendation text, evidence tables and corrigenda.
  • “Worldwide” coverage is uneven. English-language, PubMed-indexed AHA/ASA, ESO and Canadian documents are overrepresented; many national guidelines are online-only or not indexed.
  • The 2026 AHA/ASA ischemic and 2026 European aSAH documents are new at this curation date; local protocols may legitimately lag while governance and formularies update (Prabhakaran 2026, PMID 41582814; Vergouwen 2026, PMID 42095754).
  • Some topic documents age faster than broad guidelines. The 2017 ESO CVT guideline, for example, explicitly could not resolve several treatment questions and predates subsequent evidence (Ferro 2017, PMID 28833980).
  • Patient involvement, equity analysis and implementation tools are inconsistently reported. Presence of a patient representative does not quantify influence on final recommendations.

Open questions

  • Can guideline developers maintain a machine-readable supersession graph at recommendation level, so electronic protocols do not preserve obsolete fragments after a replacement (Prabhakaran 2026, PMID 41582814; Powers 2019, PMID 31662037)?
  • When AHA/ASA class/level and ESO GRADE wording differ, how often does re-grading the same evidence actually change the clinical action rather than its label (Berge 2021, PMID 33817340; Turc 2019, PMID 31165090)?
  • Do living guidelines shorten evidence-to-practice time without increasing version ambiguity or inequitable implementation (Stroke Foundation, URL above, accessed 2026-08-30)?
  • Which conditional recommendations produce the greatest practice variation and should therefore be prioritized for pragmatic randomized trials?
  • Can resource-stratified guidance be linked to financed implementation steps and population access metrics rather than remaining an aspirational checklist (Lindsay 2014, PMID 25250836)?
  • How should patients and caregivers be involved when outcomes trade survival against severe disability, particularly in ICH and aSAH guidance (Greenberg 2022, PMID 35579034; Hoh 2023, PMID 37212182)?

References

  1. Prabhakaran S, et al. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke: a guideline from the American Heart Association/American Stroke Association. Stroke. 2026;57:e316-e436. PMID 41582814
  2. Powers WJ, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 update to the 2018 guidelines. Stroke. 2019;50:e344-e418. PMID 31662037
  3. Bushnell C, et al. 2024 Guideline for the Primary Prevention of Stroke: a guideline from the American Heart Association/American Stroke Association. Stroke. 2024;55:e344-e424. PMID 39429201
  4. Kleindorfer DO, et al. 2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke. 2021;52:e364-e467. PMID 34024117
  5. Greenberg SM, et al. 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage. Stroke. 2022;53:e282-e361. PMID 35579034
  6. Hoh BL, et al. 2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage. Stroke. 2023;54:e314-e370. PMID 37212182
  7. Berge E, et al. European Stroke Organisation guidelines on intravenous thrombolysis for acute ischaemic stroke. Eur Stroke J. 2021;6:I-LXII. PMID 33817340
  8. Turc G, et al. ESO–ESMINT guidelines on mechanical thrombectomy in acute ischaemic stroke. Eur Stroke J. 2019;4:6-12. PMID 31165090
  9. Steiner T, et al. ESO–EANS guideline on stroke due to spontaneous intracerebral haemorrhage. Eur Stroke J. 2025;10:1007-1086. PMID 40401775
  10. Steiner T, et al. European Stroke Organisation guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke. 2014;9:840-855. PMID 25156220
  11. Christensen H, et al. European Stroke Organisation guideline on reversal of oral anticoagulants in acute intracerebral haemorrhage. Eur Stroke J. 2019;4:294-306. PMID 31903428
  12. Sandset EC, et al. 2025 update to European Stroke Organisation guideline on blood pressure management in acute ischaemic stroke and intracerebral haemorrhage. Eur Stroke J. 2026;11. PMID 42095756
  13. Vergouwen MDI, et al. ESO–EANS–ESMINT guideline on aneurysmal subarachnoid haemorrhage. Eur Stroke J. 2026;11. PMID 42095754
  14. Steiner T, et al. European Stroke Organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage. Cerebrovasc Dis. 2013;35:93-112. PMID 23406828
  15. Klijn CJ, et al. Antithrombotic treatment for secondary prevention in patients with stroke or TIA and non-valvular atrial fibrillation: an ESO guideline. Eur Stroke J. 2019;4:198-223. PMID 31984228
  16. Bonati LH, et al. European Stroke Organisation guideline on endarterectomy and stenting for carotid artery stenosis. Eur Stroke J. 2021;6:I. PMID 34414303
  17. Debette S, et al. ESO guideline for the management of extracranial and intracranial artery dissection. Eur Stroke J. 2021;6:XXXIX-LXXXVIII. PMID 34746432
  18. Caso V, et al. European Stroke Organisation guidelines on the diagnosis and management of patent foramen ovale after stroke. Eur Stroke J. 2024;9:800-834. PMID 38752755
  19. Wardlaw JM, et al. ESO guideline on covert cerebral small vessel disease. Eur Stroke J. 2021;6:CXI-CLXII. PMID 34414301
  20. Bersano A, et al. European Stroke Organisation guidelines on Moyamoya angiopathy. Eur Stroke J. 2023;8:55-84. PMID 37021176
  21. Ferro JM, et al. European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis. Eur J Neurol. 2017;24:1203-1213. PMID 28833980
  22. Heran M, et al. Canadian Stroke Best Practice Recommendations: Acute Stroke Management, 7th Edition Practice Guidelines Update, 2022. Can J Neurol Sci. 2024;51:1-31. PMID 36529857
  23. Gladstone DJ, et al. Canadian Stroke Best Practice Recommendations: Secondary Prevention of Stroke Update 2020. Can J Neurol Sci. 2022;49:315-337. PMID 34140063
  24. Shoamanesh A, et al. Canadian Stroke Best Practice Recommendations: Management of Spontaneous Intracerebral Hemorrhage, 7th Edition Update 2020. Int J Stroke. 2021;16:321-341. PMID 33174815
  25. Teasell R, et al. Canadian Stroke Best Practice Recommendations: Rehabilitation, Recovery, and Community Participation Following Stroke. Part One. Int J Stroke. 2020;15:763-788. PMID 31983296
  26. Lanctôt KL, et al. Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Following Stroke, 6th Edition Update 2019. Int J Stroke. 2020;15:668-688. PMID 31221036
  27. Lindsay P, et al. World Stroke Organization global stroke services guidelines and action plan. Int J Stroke. 2014;9 Suppl A100:4-13. PMID 25250836
  28. Richards LG, et al. 2026 Guideline for Adult Stroke Rehabilitation and Recovery: A Guideline From the American Heart Association and American Stroke Association. Stroke. 2026. PMID 42657476
  29. Majidi S, et al. Endovascular thrombectomy in medium and distal vessel occlusions: a focused guideline from the Society of Vascular and Interventional Neurology Guidelines and Practice Standards Committee. Stroke Vasc Interv Neurol. 2026;6:e002314. PMID 42404835