A Trial of Edaravone Dexborneol in Acute Ischemic Stroke With Active Malignancy

Inclusion Criteria: * Age between 18 and 80 years (inclusive); * Diagnosis of acute ischemic stroke (AIS) according to the 2023 Chinese Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke; * Time from symptom onset to enrollment ≤48 hours; * Presence of focal neurological deficits with a baseline NIHSS score of 4-24, and a combined score of ≥2 points on NIHSS Item 5 (upper limb motor) and Item 6 (lower limb motor); * Confirmed active malignancy before stroke onset or during hospitalization, defined as: Cancer diagnosed within 12 months prior to stroke, Presence of metastatic disease, Received cancer-directed therapy within the past 30 days, or Patients who declined cancer treatment (still considered active malignancy); * Signed informed consent obtained from the patient or legally authorized representative. Exclusion Criteria: * Intracranial hemorrhagic diseases detected on head CT: hemorrhagic stroke, epidural hematoma, intracranial hematoma, intraventricular hemorrhage, subarachnoid hemorrhage, etc; * Pre-stroke modified Rankin Scale (mRS) score \>1; * Transient ischemic attack (TIA) as the current event; * Non-invasive skin cancers (e.g., basal cell carcinoma), primary central nervous system tumors, or hematologic malignancies; * Use of neuroprotective agents, including but not limited to: marketed edaravone, nimodipine, gangliosides, citicoline, piracetam, butylphthalide, human urinary kallidinogenase, or certain Chinese herbal medicines (see Concomitant Medications for details); * Patients with severe psychiatric disorders or dementia; * Hepatic or renal dysfunction: ALT or AST \>3× upper limit of normal (ULN); Known liver diseases (e.g., acute/chronic active hepatitis, cirrhosis); Known kidney disease, renal insufficiency, serum creatinine \>1.5×ULN, or creatinine clearance \<50 mL/min; * Severe systemic diseases with an expected survival \<90 days; * Pre-stroke Eastern Cooperative Oncology Group (ECOG) performance status ≥3; * Hypersensitivity to edaravone, (+)-borneol, or any excipients; * Pregnancy, lactation, or planned pregnancy; * Participation in another clinical trial within 30 days prior to randomization or current enrollment in other interventional studies; * Any other condition deemed inappropriate for participation by the investigator.