Acute ischemic stroke (AIS) remains a leading cause of death and long-term disability worldwide. Although the new era of reperfusion therapies such as thrombolysis and thrombectomy has significantly improved outcomes, many patients fail to achieve meaningful recovery due to reperfusion injury, a paradoxical process that involves a complex cascade of excitotoxicity, oxidative stress, blood-brain barrier disruption, mitochondrial dysfunction, apoptosis, and neuroinflammation, which together limit