Neuroprotection With Statin Therapy for Acute Recovery Trial (Neu-START)

Inclusion Criteria: * Age \>18 * Satisfies the criteria for ischemic stroke: acute focal neurological deficit of likely ischemic vascular origin. * Patient or legally authorized representative has provided written informed consent prior to study entry. * Patient can receive the first treatment dose within 0-24 hours of stroke onset. For patients found with stroke on awakening, it will be assumed that the stroke occurred the last time that the patient was known to be normal. * Patient has pretreatment brain CT scan compatible with ischemic stroke and excludes hemorrhagic and non-vascular etiologies of symptoms. * Patients taking statins at time of stroke may be included. Exclusion Criteria: * Brain imaging study shows a lesion other than ischemic stroke that could explain patient's symptoms (intracranial or subarachnoid hemorrhage, arteriovenous malformation, aneurysm, multiple sclerosis, tumor, abscess or other). Asymptomatic meningiomas are allowed. * Patient had a stroke (ischemic or hemorrhagic) with residual deficit within 1 month prior to treatment. * Mild stroke, defined as NIH Stroke Scale \<2. * Patient has received or is expected to receive intravenous rt-PA within 3 hours or intra-arterial rt-PA within 6 hours of stroke onset, according to our institutional standard of care. * Receipt of intravenous rt-PA after 3 hours or intra-arterial rt-PA after 6 hours post-stroke onset. * Seizure at presentation or within two weeks prior to stroke. * Patient is comatose, regardless of etiology (\> 4 points on the first three items of the NIHSS). * History of intolerance or allergic reaction to any statins (myotoxicity, hepatic dysfunction, rash, etc.) * Use of drugs within past 30 days that utilize the cytochrome CYP3A pathway (cyclosporine, itraconazole, ketoconazole, erythromycin, azithromycin, clarithromycin, nefazodone). * Use of drugs within past 30 days that increase risk of myotoxicity with statins (gemfibrozil, other fibrates, niacin, amiodarone, verapamil). * Baseline major electrolyte disturbances (sodium \<125 or \>150, potassium \<3.0 or \>5.5). * Recent major trauma (\<3 months). * Hypothermia (body temperature \< 96 degrees Fahrenheit). * Baseline hypoxia (defined as oxygen saturation \<92% on room air). * History of likely or proven systemic viral infection within 30 days. * Known HIV infection or use of protease inhibitors. * Endocarditis likely as cause of stroke. * Mitochondrial disorder likely as cause of stroke. * Pregnancy or lactation. * History of rhabdomyolysis, myopathy, or other severe muscle disease. * History of hepatitis, decompensated liver disease (ascites, bleeding varices or encephalopathy), or liver failure. * Liver function tests (ALT, AST) \> 2X upper limit of normal. * Unstable cardiovascular (includes uncontrolled hypertension), pulmonary, gastrointestinal, hepatic or musculoskeletal disease within one month (30 days) prior to treatment (by reported history). * Patient has evidence of congestive heart failure or has history of end-stage cardiovascular disease (e.g. CHF NYHA Class III or IV or unstable angina). * Abnormal ECG showing: Hemodynamically significant arrhythmia or frequent PVCs (\>5/minute) (controlled atrial arrhythmia will not be an exclusion); evidence of acute myocardial infarction; Mobitz Type II 2nd degree AV block or 3rd degree AV block; ventricular tachycardia or ventricular fibrillation. * Significant renal insufficiency, indicated by serum creatinine \>2.0 mg/dl. * Hypoglycemia (glucose \< 60 mg/dl), significant hyperglycemia (glucose \> 400 mg/dl) or diabetic ketoacidosis. * Any of these hematologic abnormalities: Hb \<10 g/dl; WBC \<3.0 x 103/mm3; Platelet count \<50,000/mm3 * Received an investigational drug within 30 days. * Severe behavioral or social problems that may interfere with the conduct of clinical study procedures.