ABSTRACT

INTRODUCTION. Stroke remains one of the leading causes of mortality and disability worldwide. Despite advances in reperfusion therapy (thrombolysis and thrombectomy), a significant proportion of patients retain severe neurological deficits. Standard protocols, which do not account for the diversity of strokes, reduce treatment effectiveness, necessitating the implementation of a personalized approach.

AIM. To present a review of literature data on the principles of stroke treatment stratification, as well as modern approaches to neuroprotection, neuroregeneration, and rehabilitation of patients with cerebrovascular pathology.

MATERIALS AND METHODS. An analysis of 32 literature sources was conducted based on the RINTs and PubMed databases for the period 2020–2025 regarding stroke treatment stratification and precision neurology. Materials on the application of neuroimaging methods, pharmacogenetic profiling, neuromodulation, and telemedicine technologies in the acute and recovery periods of the disease were analyzed.

RESULTS AND DISCUSSION. A concept of stroke treatment stratification has been proposed: the division of patients into groups depending on pathogenetic features, the time window and the prognosis of recovery. Modern strategies for neuroprotection in the acute period, methods for stimulating neuroregeneration in the subacute and recovery periods, and algorithms for personalized neurorehabilitation are considered. Particular attention is paid to the transition from empirical treatment to precision medicine in cerebrovascular pathology.

CONCLUSION. Effective stroke treatment requires a transition from static unified protocols to dynamic personalized strategies. Only a systemic interdisciplinary approach is capable of reducing the burden of disability and improving the quality of life of patients. 

KEYWORDS: ischemic stroke, hemorrhagic stroke, patient stratification, neuroprotection, neuroregeneration, neurorehabilitation, neuroplasticity

For citation: Adambaev Z.I., Samiev A.S., Zukhritdinov U.Yu., Pazylova A.S., Okhunov I.U., Saparbayev K.I., Korayeva L.K. Stroke Treatment Stratification: Integration of Neuroprotection, Neuroregeneration and Rehabilitation Approaches. A Review. Comorbidity Neurology. 2026; 3 (2): 22–31. https://doi.org/10.62505/3034-185x-2026-3-2-22-31

*For correspondence: Zufar I. Adambayev, Dr. Sci. (Med.), Associate Professor, Acting Professor of the Department of Neurology, Psychiatry and Medical Psychology, Urgench State Medical Institute, Urgench, Uzbekistan, e-mail: zufargms68@gmail.com.

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ADDITIONAL INFORMATION

Zufar I. Adambayev, Dr. Sci. (Med.), Associate Professor, Acting Professor of the Department of Neurology, Psychiatry and Medical Psychology, Urgench State Medical Institute, Urgench, Uzbekistan. E-mail: zufargms68@gmail.com. ORCID: https://orcid.org/0009-0001-0193-592X

Asliddin S. Samiev, Dr. Sci. (Med.), Associate Professor, Department of Neurology, Faculty of Postgraduate Education, Samarkand State Medical University, Samarkand, Uzbekistan. E-mail: asliddinsayitovich@gmail.com. ORCID: https://orcid.org/0009-0004-9771-9712

Utkirbek Yu. Zukhritdinov, Ph.D., Head of the Neurology Department, Andijan Regional Multidisciplinary Medical Center, Andijan, Uzbekistan. E-mail: zuxritdinov86@mail.ru.com. ORCID: https://orcid.org/0009-0005-9909-8400

Aida S. Pazylova, Neurologist, International School of Medicine, Educational-Scientific-Production Complex "International University of Kyrgyzstan", Bishkek, Kyrgyzstan. E-mail: zufargms68@gmail.com. ORCID: https://orcid.org/0009-0009-7626-0574

Ibrokhimjon U. Okhunov, Neurologist, Multidisciplinary Medical Center of Fergana Region, Fergana, Uzbekistan. E-mail: oxunovibroximjon1993@gmail.com. ORCID: https://orcid.org/0009-0005-0605-8267

Kudrat I. Saparbayev, Neurologist, "Surge Land" Clinic, Urgench, Uzbekistan. E-mail: kliniknevrolog@gmail.com. ORCID: https://orcid.org/0009-0001-7231-213X

Lobar K. Korayeva, Head of the Neurology Department, Ibn Sina City Clinical Hospital, Tashkent, Uzbekistan. E-mail: karayevalobar3@gmail.com. ORCID: https://orcid.org/0009-0005-4762-830X

Author contributions. All authors confirm that their authorship complies with the international ICMJE criteria (all authors made a significant contribution to the conception, conduct of the study and the preparation of the article; read and approved the final version before publication). Special contributions: Adambaev Z.I. – conceptualization, methodology, investigation, writing original draft, visualization, supervision; Samiev A.S. – data curation, writing – review and editing; Zukhritdinov U.Yu. – resources, software; Pazylova A.S., Okhunov I.U., Saparbayev K.I., Korayeva L.K. – software, validation, formal analysis.

Funding. This study was not supported by any external sources of funding.

Disclosure. The authors declare no apparent or potential conflicts of interest related to the publication of this article.

The content is available under the Creative Commons Attribution 4.0 License.

©2026. Zufar I. Adambayev, Asliddin S. Samiev, Utkirbek Yu. Zukhritdinov, Aida S. Pazylova, Ibrokhimjon U. Okhunov, Kudrat I. Saparbayev, Lobar K. Korayeva