Select people who have (in addition to the factors in a pre-stroke functional status of less than 3 on the modified Rankin scale and a score of more than 5 on the National Institutes of Health Stroke Scale For a short explanation of why the committee made these 2019 recommendations and how they might affect practice, see the rationale and impact section on thrombectomy for people with acute ischaemic stroke. Full details of the evidence and the committee's discussion are in evidence review D: thrombectomy. 2022 Aspirin and anticoagulant treatment People with acute ischaemic stroke 1.4.9 Offer the following as soon as possible, but certainly within 24 hours, to everyone presenting with acute stroke who has had a diagnosis of intracerebral haemorrhage excluded by brain imaging: aspirin 300 mg orally if they do not have dysphagia or aspirin 300 mg rectally or by enteral tube if they do have dysphagia. Continue aspirin daily 300 mg until 2 weeks after the onset of stroke symptoms, at which time start definitive long-term antithrombotic treatment. Start people on long-term treatment earlier if they are being discharged before 1.4.10 Offer a proton pump inhibitor, in addition to aspirin, to anyone with acute ischaemic stroke for whom previous dyspepsia associated with aspirin is 1.4.11 Offer an alternative antiplatelet agent to anyone with acute ischaemic stroke who is allergic to or genuinely intolerant of aspirin. (Aspirin intolerance is defined as either of the following: proven hypersensitivity to aspirin-containing medicines, or history of severe dyspepsia induced by low-dose aspirin.) [2008] 1.4.12 Do not use anticoagulation treatment routinely for the treatment of acute stroke (see additional information). 