The invention relates to the treatment of
ischemic stroke at risk of
brain swelling using SUR1-TRPM4 channel inhibitors 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
lesion volume of less than 140 cm3 or less than 125 cm3 as measured by MRI DWI or CTP. The patient may have suffered a wake-up
stroke. Some embodiments involve treating patients who also undergo decompressive therapy.