From the Research
A subacute stroke typically refers to the period between 24 hours and 2 weeks after the initial stroke event, as defined by the time when the decision to not employ thrombolytics is made up until two weeks after the stroke occurred 1. This timeframe is critical for rehabilitation interventions, as neuroplasticity—the brain's ability to reorganize and form new neural connections—is particularly enhanced during this time. Some studies suggest that the subacute phase may extend up to 3 weeks after the initial stroke event, but the most recent and highest quality evidence supports the 2-week definition 1. Key aspects of management during the subacute phase include:
- Preventing complications such as venous thromboembolism, pressure sores, infection, and delirium
- Optimizing secondary prevention strategies, including antiplatelet therapy with aspirin or clopidogrel
- Initiating appropriate rehabilitation therapies, such as physical, occupational, and speech therapy
- Managing blood pressure, typically aiming for targets below 140/90 mmHg, though this may be individualized The subacute phase is a critical period for coordinating ongoing care and recovery support, as many patients transition from acute hospital care to rehabilitation settings or home with outpatient services. While some studies have investigated the use of dual antiplatelet therapy during the subacute phase 2, the primary focus remains on preventing complications and optimizing rehabilitation interventions. Overall, the subacute phase of stroke recovery is a complex and critical period that requires careful management to minimize morbidity and mortality and improve quality of life.