Abstract
Ischemic stroke exhibits considerable variability across regions, age groups, sexes, and ethnicities, with risk factors encompassing genetic, environmental, and socioeconomic dimensions. Its pathophysiology is multifaceted and involves disturbances in energy metabolism, disruption of the BBB, and inflammatory processes, among other mechanisms. Diagnostic advancements including imaging modalities, biomarker identification, and artificial intelligence applications have significantly enhanced clinical practice. Therapeutic strategies primarily focus on reperfusion and antiplatelet therapies, while traditional Chinese medicine (TCM) demonstrates potential through multi-targeted and multi-modal approaches. Rehabilitation and prevention efforts underscore the importance of multidisciplinary collaboration, personalized treatment plans, and early risk factor interventions. Rooted in the traditional conceptualization of stroke, TCM exerts its effects via anti-inflammatory, antioxidant, and metabolic regulatory pathways, and has shown promising clinical outcomes when integrated with conventional medicine. Nonetheless, challenges remain regarding the robustness of the efficacy evidence, standardization of syndrome differentiation, and safety concerns. Future directions point toward the integration of multi-omics technologies, artificial intelligence, precision medicine, and international collaboration to advance the comprehensive management of ischemic stroke by incorporating TCM.