Treatment of patients with ischemic stroke in the vertebral-baslar system in the acute period: Experience in the use of the neuroprotective drug Mexidol

Authors:
Z. A. GONCHAROVA, I. V. CHERNIKOVA, V. A. NAZAROVA, V. V. TOLMACHEVA, K. G. OVSEPYAN
Rostov State Medical University of the Ministry of Health of the Russian Federation, Rostov-on-Don, Russia

Place of publication:
S.S. KORSAKOV JOURNAL OF NEUROLOGY AND PSYCHIATRY, 2024, Vol. 124, No. 2

Abstract:
The aim of the study was to evaluate the clinical efficacy and safety of Mexidol in patients with acute ischemic stroke in the vertebrobasilar system (IVBS).

Material and methods. Fifty-two patients participated in an open, randomized comparative study, of which 32 received Mexidol (the main group, MG) and 20 received standard therapy without neuroprotective drugs (the comparison group). The severity of clinical manifestations of iIBS was assessed using the Hoffenberth scale, stroke severity was assessed using the NIHSS scale, the degree of patient disability after stroke was assessed using the Rankin scale, neuropsychological examination of patients was conducted using the Montreal Cognitive Assessment (MoCA), the Hospital Anxiety and Depression Scale (HADS), and the Asthenia Rating Scale (MFI-20), and the quality of life of patients was assessed using the EQ-5D questionnaire.

Results. Long-term sequential use of Mexidol in patients with MG resulted in a 53.3% reduction in the severity of clinical manifestations of iVBS and a 59.5% reduction in neurological deficits according to the NIHSS scale. By the end of Mexidol therapy, 96.9% of patients were able to manage their daily activities without assistance, which was accompanied by a regression of emotional disturbances and an improvement in their quality of life.

Conclusion. Early administration of Mexidol in the treatment of patients with iVBS can be considered the most justified, as it promotes an earlier and more significant reduction in neurological deficits and an improvement in patients' quality of life.

Key words: cerebrovascular diseases, ischemic stroke in the vertebrobasilar system, vertebrobasilar insufficiency, neuroprotective therapy, Mexidol.