[Therapeutic objectives in the subacute phase after stroke].

The aim of this study was to identify the most appropriate clinical management of the subacute stage after stroke, in order to reduce mortality and control disability following cerebrovascular disease. Data were collected from international journals, books and guidelines written by accredited agencies and scientific societies. Reviews and clinical investigations written by authors operating in stroke assistance facilities have been selected among those submitted to accredited scientific journals, spontaneously or upon request by editors of specific sections or supplements. Furthermore, the guidelines proposed by either scientific or lay associations have been considered. The following elements have been considered: i) prevention of morbidity and treatment of complications in the subacute phase; ii) identification of uncommon stroke causative factors in order to prevent recurrent events; iii) prognosis of survival and disability; iv) activation of rehabilitation. Results show that a careful evaluation of stroke etiology and the direct management of cerebrovascular problems by specialized utilities bring about an increase in survival rate and reduce disability. The treatment of complications, the evaluation of recovery capacity and the accomplishment of rehabilitation strategies, based on accredited criteria of organization, allow an increase in the efficiency of assistance facilities. Involvement of the family has a positive influence on autonomy. In conclusion, the qualified management of stroke patients can reduce mortality and disability, even if there is still no effective therapy, capable of reducing cerebral damage.