Early Feasibility Study of the Nervive VitalFlow Stimulation for Acute Ischemic Stroke Patients

Inclusion Criteria: - Time last known normal within 4.5 hours of presentation for enrollment - Allows 1.5 hours for pre-stimulation study procedures to maintain a 6-hour therapeutic window - IV rtPA and Endovascular Treatment (EVT) permissible if not inappropriately delayed by study procedures - Age 18-85 years - Diagnosis of ischemic stroke in the anterior circulation - NIHSS at baseline 4-20 - Creatinine < 1.7 mg/dL - Signed informed consent by patient/Legally Authorized Representative (LAR) Exclusion Criteria: - Pre-stroke disability Modified Rankin Score (mRS) between 2-6 - Inability to communicate sufficiently to participate in study procedures - Neuroimaging with intracranial hemorrhage, severe brain edema, or ASPECTS <5 - Known or newly-discovered aneurysm or arteriovenous malformation (AVM) - Intracranial mass lesion, infection, or other reason to suspect increased intracranial pressure - Metallic foreign bodies or implanted devices in the head or neck, including tattoos - Cardiac, vagal nerve, or intracranial neural stimulation device - Cochlear implant or implanted hearing aid - Potential for delay in intravenous rtPA or endovascular therapy due to study procedures - Intravenous (IV) rtPA: Stimulation might be delivered during the rtPA infusion period - EVT: Stimulation might be performed while EVT team is mobilized - Seizure concurrent to stroke, or history of seizures, epilepsy, or recurrent syncopal events. - History of neuropathy (including facial nerve injury), carotid surgery, or vagotomy.