Extending treatment windows while managing high‑risk bleeding complications

This cluster highlights how acute stroke care is evolving beyond rigid time cutoffs toward individualized, physiology-based decisions. Advanced brain imaging is allowing clinicians to safely extend the treatment window for selected ischemic stroke patients, sometimes well past 24 hours, by identifying salvageable brain tissue. At the same time, there is growing urgency to optimize rapid reversal protocols and transfer pathways for anticoagulation-associated intracerebral hemorrhage, a particularly lethal stroke complication. Together, these developments aim to maximize benefit and minimize harm across the full spectrum of acute cerebrovascular emergencies.