Introduction
Acute ischemic stroke is the second leading cause of death and one of
the most common causes of adult disability worldwide [1].
Thrombolytic therapy within 4.5 hours after stroke onset can
significantly reduce mortality and morbidity. However, the effect is
negligible after 4.5–6 hours and useful for only a small portion of
patients [1]. Therefore, many therapeutic strategies have been
developed targeting the pathophysiological cascade that starts with
ischemia and ultimately leads to irreversible tissue damage [ 2].
One of the most effective neuroprotective drugs used in the acute phase
of ischemic stroke is Cerebrolysin, which consists of low molecular
weight peptides and free amino acids and has been shown to exert both
neuroprotective and neurotrophic effects [ 1-4]. A meta-analysis of
these studies confirmed the beneficial effect of Cerebrolysin on the
early recovery of neurological deficits in patients with acute ischemic
stroke [1, 5, 6]. Acetylsalicylic acid (aspirin) is widely used as
secondary preventive drug in stroke therapy. In ischemic stroke aspirin
in high doses of 160-326 mg is used to achieve antithrombotic as well as
neuroprotective effects [7]. Antithrombotic treatment is an
effective management tool for acute ischemic stroke and early secondary
prevention as it reduces the risk of recurrent ischemic stroke with a
low risk of hemorrhagic complications [7]. The combination of high
doses of aspirin and Cerebrolysin may have a potential effect in cases
of ischemic stroke.