During the last years, the care of stroke patients has dramatically changed with the advent of new treatments such as thrombolysis, and the development of specialized units such as stroke units. Following the acute phase, the management of residual signs is also evolving with the development of specialized rehabilitation units, the treatment of dementia and new hopes for the future such as cell transplantation, Transcranial Magnetic Stimulation or cortical stimulation. Theses advances stress the need for an accurate determination of stroke signs and complications both at the acute and late phases. This is a vast domain considering the extraordinary complexity of the brain and the multiple mechanisms of stroke. This domain is also rapidly evolving owing to the major advances in neurosciences and neuropsychology.

For the clinician, the development of cognitive and clinical neurosciences has shed light on the interpretation, assessment, diagnosis and prognosis value of stroke signs and their treatments. The objectives of cognitive examination differ according to the phase. At the hyperacute phase, the recognition of stroke signs is essential for diagnosis and prognosis purposes.