Impact of Edaravone on Short‐Term and Long‐Term Motor Recovery After Acute Ischemic Stroke in Patients Who Did Not Receive Thrombolytic or Endovascular Treatment

Background Many patients with acute ischemic stroke (AIS) are ineligible for thrombolysis. Evidence on edaravone in this population is limited. Methods This study is a retrospective cohort study on adults with imaging‐confirmed AIS admitted to Shohada‐e‐Ashayer Hospital (March 2022–February 2023) who did not receive thrombolysis. Patients who received intravenous edaravone within the first day of onset plus standard care were compared with standard care alone. Motor strength was assessed with the Medical Research Council (MRC) scale (0–5) at baseline, 1 week, and 3 months. The primary outcome was 3‐month motor function; secondary outcomes included ≥ 2‐point improvement from baseline. Result Among 160 patients ( n = 80 edaravone; n = 80 control), baseline characteristics were similar. At 3 months, the intervention group had higher MRC grades and a higher proportion achieving ≥ 2‐grade improvement; 1‐week differences were not significant. Conclusions In AIS patients ineligible for thrombolysis, edaravone was associated with better 3‐month motor strength; no significant between‐group differences were observed at 1 week. Prospective randomized trials are warranted.