Inclusion Criteria1. All patients who are 18 years or older, presenting or admitted to the Doylestown Hospital with acute ischemic stroke, 4.5 hours or longer but not more than 24 hours since their last known well time
2. An MRI evidence of acute ischemic infarct on the diffusion-weighted imaging with ADC correlate
3. Pre-stroke modified Rankin scale of 0-2
4. Patient should be willing to participate in the study by providing a written consent himself/herself or through a proxy.
Exclusion Criteria1. Eligibility to receive IV alteplase or intra-arterial thrombectomy/embolectomy
2. Longer than 24 hours since last known well time
3. Pre-stroke modified Rankin scale of 3 or above.
4. Pregnant or lactating females
5. Pre-existing psychiatric illness
6. Intracranial hemorrhage of any type at presentation
7. Seizure at onset of symptoms
8. Inability/refusal to provide consent by the patient or through a proxy