Objective      To evaluate cerebral reperfusion in patients treated with aggressive medical management for acute ischemic stroke.       Methods      Clinical data of 15 patients with acute ischemic stroke at one side of cerebral hemisphere in our department from September 2013 to June 2014 were collected and analyzed in this study. All the patients received MRI perfusion-arterial spin labeling imaging (ASL) for 2 times

before aggressive medical management and in 24 h later. Cerebral blood flow (CBF) maps were preprocessed by SPM 8 software and compared between pre- and post-treatment. The cohort was followed up for 3 months. An intention-to treat analysis was carried out with primary outcome as any stroke during 90 d of follow-up.       Results      In 7 d after aggressive treatment

the National Institute of Health stroke scale (NIHSS) were decreased from 7.20±2.76 before treatment to 5.47±2.56 (P0.01). In 90 d after the treatment

modified Rankin Scores (mRS) were deceased from 3.93±0.26 at admission to 3.00±0.66 (P0.05). ASL results showed that regional cerebral blood flow (rCBF) was profoundly improved than before treatment (P0.05).       Conclusion      Aggressive medical management improves early rCBF and reperfusion.