Previous studies have reported that serum NfL levels increase over time up to two weeks after acute ischemic stroke and are maintained for 3 to 6 months.[9,10,15,16] Cerebral arterial occlusion induces neuronal necrosis followed by secondary injury via immune and inflammatory processes.[17] Our results suggest that both acute and subsequent neuroaxonal injury after acute ischemic stroke may contribute to increased NfL7D levels after ischemic stroke. Here, NEFL is linked to ischemic stroke.