Can a drug boost brain recovery after stroke?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Age 18 to 80 years. * Acute anterior-circulation ischemic stroke caused by internal carotid artery or M1 or M2 middle cerebral artery occlusion confirmed by computed tomography angiography. * Stroke onset-to-groin-puncture interval greater than 6 hours and no more than 24 hours. * Prestroke modified Rankin Scale score of 0 to 2. * Baseline National Institutes of Health Stroke Scale score of at least 6 with cortical signs. * Alberta Stroke Program Early Computed Tomography Score greater than 3. * Computed tomography perfusion target mismatch defined as ischemic core volume less than 70 mL, mismatch ratio at least 1.8, and mismatch volume at least 15 mL. * Moderate-to-good collateral circulation, defined as filling of more than 50% of the middle cerebral artery territory on computed tomography angiography. * Successful endovascular reperfusion, defined as modified Thrombolysis in Cerebral Infarction grade 2b or 3, confirmed before randomization. * Study treatment can be initiated within 36 hours of stroke onset. * Written informed consent obtained before randomization from the participant or a legally authorized representative. Exclusion Criteria: * Life expectancy less than 6 months or a serious medical, neurological, or psychiatric condition likely to interfere with study treatment, follow-up, or outcome assessment. * Current pregnancy or breastfeeding. * Known iodinated contrast allergy that precludes required endovascular or imaging procedures. * Acute or chronic renal failure with creatinine clearance less than 30 mL/min. * Known hypersensitivity or contraindication to Cerebrolysin. * Aspartate aminotransferase or alanine aminotransferase greater than 2 times the upper limit of normal, or total bilirubin greater than 2 mg/dL. * Blood glucose less than 50 mg/dL or greater than 400 mg/dL. * Platelet count less than 50,000/mm3 or international normalized ratio greater than 3. * Seizure at stroke onset that prevents reliable neurological assessment. * Pre-existing intracranial hemorrhage or multiple vascular occlusions on baseline neuroimaging.