The invention relates to the treatment of
ischemic stroke at risk of
brain swelling using SUR1-TRPM4 channel inhibitors. In some embodiments, the SUR1-TRPM4 channel inhibitor is used in combination with
mechanical thrombectomy. In some embodiments, the methods include treating patients suffering from a large hemispheric
infarction. In certain embodiments, patients have a baseline NIHSS of ≤ 20. In certain embodiments, patients have a
lesion volume of less than 300 cm3, less than 140 cm3, or less than 125 cm3 as measured by MRI DWI or CTP. In certain embodiments, patients have a
lesion volume expanding at a rate or < 25 mL / h. The patient may have suffered a wake-up
stroke. Some embodiments involve treating patients who also undergo treatment with a
thrombolytic agent and / or decompressive therapy.