The paper gives the data of Russian and foreign studies on the pathophysiological mechanisms of brain injury in ischemic and hemorrhagic
stroke, the specific features of brain plasticity and its activation after cerebral stroke, and main directions for basic and differentiation therapy for acute cerebrovascular pathology. Particular emphasis is placed on the issues of cytoprotective and neurotrophic therapy for cerebral stroke. Analysis of the data available in the literature shows that cytoprotective and neurotrophic therapies are important components of combination treatment in patients with stroke and favorably affect the functional outcome of the disease.