Background: After good recovery noted from Intracarotid Sodium Nitroprusside (ICSNP) previous studies in rats and then humans, there was always a hitch in preinjection period that whether this ICSNP will benefit the recipient or not. Sodium Nitroprusside (SNP) via its 10000 fold effect, is used in out timed InjrTPA (Recombinant Tissue
Plasminogen Activator) cases (5 days to 21 days) of ischemic stroke while skipping local induced Nitric Oxide Synthase Enzyme (i NOS) and superoxide (causes destructive effect) formation.Acupunture Like-Transepidermal Neural Stimulation (AL-TENS) used here for quantitative measure of the stroke recovery bedside other than NIHSS grading to evaluate the ICSNP effect.AL-TENS causes pain relief by gate theory at spinal cord with negative inputs from brain on Renshaw cells.

Objective: To prognosticate the POST-ICSNP effect by AL-TENS in humans of delayed ischemic stroke from 5th to21st day by AL-TENS, a Prospective-study.

Material and Methods: 27 ischemic stroke patients (18 male, 9 females) taken. Mean time was 7 days. Dose 0.01
mg/kg/bo/wt at ipsilateral to MRI/CT SCAN indicated infarct, carotid artery direct puncture via 20G Medikit given. Study was monitored by AL-TENS and NIHSS grading.

Results: POST-ICSNP AL-TENS showed 16.66% benefit and 30.12% in NIHSS grading overall. Thus AL-TENSshowed a favorable modality to predict the ICSNP feasibility in partial hemiplegia cases that is LACS, PACS and POCS. Complete hemiplegia with major artery block cases, PRE-ICSNP AL-TENS showed 8mAmp or more - noresponse to ITSNP.

Conclusions: AL-TENS helps us to prognosticate outcome in partial hemiplegia with ICSNP.

Keywords: Acute ischemic stroke; Intracarotid sodium nitroprusside; Acupuncture-like tens (al-tens); The 10,000 fold effect.

Key Message: This study is very crucial one for the acute ischemic stroke cases who comes after the lapse periodof rTPA injection that is after 6 hours of acute ischemic infarct.