For patients with large vessel occlusion (LVO) stroke, 0° head positioning helps to maintain clinical stability and prevent exacerbation as they await thrombectomy, new research shows. The prospective randomized clinical trial examined the value of a 0° head position compared with a 30° head position in patients with LVO stroke who were candidates for thrombectomy and had viable penumbra within 24 hours of stroke onset. The study, conducted at certified U.S. thrombectomy hospitals, included 92 patients. Participants were randomized to 0° or 30° head positioning, with monitoring every 10 minutes. The primary endpoint was early neurological deterioration, with worsening of  ≥2 points on the National Institutes of Health Stroke Scale (NIHSS) before thrombectomy. While patients in the 0° head position had score stability, those in the 30° head position group had a 34.4-fold increased risk of clinical worsening before thrombectomy. During positioning, one patient with 0° head positioning and 20 with 30° head positioning saw their NIHSS by 4 points or more. No patients developed hospital-acquired pneumonia; however, there were two all-cause deaths in the 0° group vs. 10 in the 30° head positioning group.