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.