The symptoms of brain ischemia may be transient, lasting seconds to minutes, or may persist for longer periods. Symptoms and signs remain indefinitely if the brain becomes irreversibly damaged and infarction occurs. Unfortunately, neurologic symptoms do not accurately reflect the presence or absence of infarction, and the tempo of the symptoms does not indicate the cause of the ischemia. This is a critical issue because treatment depends upon accurately identifying the cause of symptoms.
The subacute and long-term assessment and management of patients who have suffered a stroke includes physical therapy and testing to determine the precise etiology of the event to prevent recurrence. The acute management differs. Immediate goals include minimizing brain injury, treating medical complications, and moving toward uncovering the pathophysiologic basis of the patient's symptoms.