Neuro MD #11 discusses the new ASA/AHA guidelines for the management of acute ischemic stroke (AIS). The new recommendations bring changes that are built on stronger data. When large vessel occlusion (LVO) is suspected and RACE score > 4, it is important to transport the patient to a center capable of performing thrombectomy (TSC), if nearby. If the TSC is 45-60 minutes away, transport to a local center with IVT administration and subsequent secondary transfer is more appropriate. After IVT/EVT, it is recommended to correct the pressure below 180/105 mmHg, but above 140/90 mmHg. In patients without IVT/EVT, pressure up to 220/120 mmHg is tolerated, while lowering the pressure below this value has no benefit for the first 48-72 hours.