Pathological mechanisms and interventions during the recovery phase of ischemic stroke

Ischemic stroke is the most prevalent type of stroke worldwide and remains a leading cause of mortality and long-term disability among older adults. Currently, studies on the acute phase are relatively mature, but pathophysiological mechanisms driving progressive neuronal loss during the recovery phase remain insufficiently understood. In accordance with the SRRR international consensus, this review defines the “recovery phase”—specifically the subacute phase, spanning from 7 days to 6 months post-stroke—as the critical therapeutic window for functional rehabilitation. Neuroplasticity is critical during this phase, while neuroinflammation, glial scarring, and demyelination are intertwined to influence the recovery process. This interplay creates a multifaceted microenvironment where reparative and degenerative processes coexist. Despite the therapeutic potential of TCM and stem cell therapies in multi-target modulation, their clinical translation is still constrained by varying levels of evidence. This review aims to elucidate the core pathological mechanisms of ischemic stroke during the recovery phase and critically evaluate relevant interventions, providing a solid theoretical foundation for the development of future precision clinical treatments.