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The effect of therapy with the drug Mexol on the regression of neurological deficiency and a functional outcome in patients with ischemic stroke: a systematic review and meta analysis

Authors:
I.A. Voznyuk 1.2 , S.V. Kolomensev 2.3 , E.M. Morozova 1

1 FSBEI in "First St. Petersburg State Medical University named after I.P. Pavlova "of the Ministry of Health of Russia, St. Petersburg, Russia;
2 Baltic Center for Neurotechnology and Artificial Intelligence FGAOU in Baltic Federal University named after Immanuel Kant ”, Kaliningrad, Russia;
3 FSBVOU in the "Military Medical Academy named after CM. Kirova »Ministry of Defense of Russia, St. Petersburg, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 12, Issue. 2

Summary:
Purpose of the study. A systematic assessment of information published in the reviewed publications on the effect of therapy with Mexidol with the course and outcome of ischemic stroke (AI) in adult patients.

Material and methods. The meta-analysis includes 11 studies published in Russian (2-randomized controlled, 9-incomeized unraveling cohort studies).

Results. Data was obtained indicating the positive effect of Mexol's drug on the course of AI in adult patients: statistically significant, when comparing with the comparison group, a decrease in the NIHSS scale on the 7-10s and 21-24 days and the values ​​of the modified Rankin scale by 5- 7th and 10-14th day. The accumulative effect of the drug is shown: the difference in values ​​on the NIHSS scale grows as the observation duration increases. The effect of Mexidol’s influence on the indicators on the NIHSS scale is all the more significant, the greater the initial severity of the neurological deficit.

Conclusion. The heterogeneity of the design and characteristics of patients led to significant statistical heterogeneity, and therefore the evidence presented at the time of writing the review require further study, taking into account the emergence of new data.

Keywords: ischemic stroke, neuroprotection, Mexidol, ethyl-methylhydroxypyridine succinate, meta-analysis, NIHSS scale, modified Rankin scale, cerebrovascular diseases.

Arterial hypertension and cognitive disorders. The gaze of a neurologist

Author:
A.I. Fedin

FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 11

Summary:
a review of the literature on the relationship of cognitive disorders (KN) with arterial hypertension (AH) is presented. The pathogenetic mechanisms of AH are associated with the development of cerebral microangiopathy. In antihypertensive therapy (AGT), disorders of the autoregulation of cerebral blood flow should be taken into account with cerebrovascular disease and critical stenosis of large brain arteries, especially in patients over 80 years old. The importance of AGT, focused on the level of cerebral perfusion pressure, the severity of KN and the physical functioning of patients, is emphasized. Neurocytoprotective therapy is recommended for the correction of KN.

Key words: arterial hypertension, cognitive disorders, antihypertensive therapy, cerebral perfusion pressure.

Approaches to pharmacotherapy of vascular moderate cognitive disorders in patients of various age groups

Authors:
V.V. Zakharov 1 , A.I. Fedin 2 , E.A. Mkhitaryan 2, 3

1 FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
2 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
3 Russian gerontological scientific and clinical center of the FGAOU in the Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 10

Summary:
the article discusses the possibilities of pharmacotherapy of vascular moderate cognitive disorders in various age groups. The results of a double blind randomized clinical examination of MEMO using an antioxidant and anti -hyphyxant drug Mexidol are given. Using a set of tests for evaluating cognitive functions, the high efficiency of the sequential purpose of the parenteral and oral form of Mexidol in each of the three analyzed groups is shown: 40-60, 61-75 and 76-90 years. In all age groups, Mexidol demonstrated a high security profile.

Key words: vascular moderate cognitive impairment, chronic brain ischemia, antioxidants, Mexidol.

Features of pharmacotherapy of vascular cognitive impairment in elderly people

Author:
A.N. Bogolepova 1, 2

1 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
2 FSBI "Federal Center for Brain and Neurotechnology" of the Federal Medical and Biological Agency of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 9

Summary:
the problem of pharmacotherapy of elderly and senile age is currently extremely relevant due to the aging of the population and the growth of the prevalence of cardiovascular diseases. One of the most serious problems of an elderly person is the development of a cognitive decline due to cerebrovascular pathology. However, in elderly patients, a large number of comorbid diseases are often observed, which leads to the difficulties of the diagnosis and conduct of these patients, and often to the development of polypragmasis, which can lead to a deterioration in functional status, cognitive impairment, side reactions and drug interactions. In addition, older patients may observe changes in pharmacokinetics and pharmacodynamics due to anatomical and physiological invoices. At the same time, drugs whose effectiveness and tolerance were evaluated precisely in elderly and senile patients, relatively few. In a randomized clinical examination of consistent parenteral and oral therapy, Mexidol's patients with moderate cognitive disorder of vascular genesis confirmed the positive effect of this therapy on various domains (cognitive, emotional, vegetative, motor) of chronic cerebrovascular disease, which allows us to recommend it for the use of elderly elderly elders. and senile age.

Keywords: vascular cognitive disorders, elderly patient, pharmacotherapy, ethylmethylhydroxyperidine succinate, Mexidol.

Increasing the efficiency of pharmacotherapy in comorbide patients with chronic brain ischemia on an outpatient basis

Authors:
T.L. Visil 1 , E.G. Arefieva 2

1 FSBEI in Kemerovo State Medical University of the Ministry of Health of Russia, Kemerovo, Russia;
2 GBOUZ "Kuzbass Clinical Cardiological Dispensary named after Academician L.S. Barbarash ", Kemerovo, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 3

Summary:
Purpose of the study. Studying the effectiveness and safety of consistent therapy with Mexidol preparations (500 mg 1 time per day for 14 days in/c) and Mexidol Fort 250 (Mexol Fort 250 by 250 mg 3 times a day, 60 days) in patients with chronic brain ischemia ( Chem) on an outpatient basis.

Material and methods. The open comparative study included 56 patients aged 46–74 years (average - 60.5 ± 7.9 years). In all patients, the diagnosis of Khim was confirmed by clinical and neuroizialization methods. Patients of the 1st group (n = 28) received basic therapy and Mexidol, the 2nd group (n = 28)-only basic therapy.

Results. Against the background of therapy in patients of the 1st group, there was a statistically significant improvement in the state of cognitive functions, a decrease in the severity of the symptoms of depression and anxiety, and manifestations of asthenia. The treatment was characterized by good tolerance, the absence of undesirable phenomena and cases of drug interactions.

Conclusion. Consistent therapy with Mexidol and Mexidol Forte 250 ensures the relief of the main clinical manifestations of chemicals, is characterized by good tolerance and safety.

Keywords: chronic brain ischemia, arterial hypertension, ethylmethylhydroxypyrididine Succinate, Mexidol, Mexidol Forte 250.

The possibilities of multimodal neuroprotection in patients with chronic brain ischemia against the background of arterial hypertension and atherosclerosis

Authors:
I.A. Gribacheva, T.F. Popova, E.V. Petrova, A.V. Zvonkova

FSBEI in Novosibirsk State Medical University of the Ministry of Health of Russia

Place of publication:
neurology, neuropsychiatry, psychosomatics. 2023; 15 (2): 19–26

Summary:
chronic cerebrovascular pathology is manifested by a combination of cognitive, emotional and autonomic disorders. The correct timely assessment and accurate diagnosis of emotional and autonomic disorders and their timely correction are also important for slowing down the progression of cognitive deficiency.

The purpose of the study is to study the effectiveness and safety of the use of Mexidol, prescribed intravenously (500 mg 1 time per day) within 14 days, with the subsequent oral administration of the drug Mexidol Forte 250 in a dose of 250 mg 3 times a day for 60 days in middle patients with medium -sized patients with chronic ischemia of the brain (HIGM) against the background of arterial hypertension and atherosclerosis.

Material and methods. The open observation program included 60 patients aged 45 to 59 years with HIGM confirmed by the results of neuropsychological and neuroimaging examination, who received Mexidol in the beginning of intravenously (14 days), and then in the form of a tablet form - Mexidol Forte 250 (60 days) . Patients conducted neuropsychological testing, assessment of the level of reactive and personal anxiety (Spielberger-Khanin scale), the nature of vegetative support (the scale of the Vegetative reactions of A.M. Wein in the modification of V.L. Golubev), the severity of general, mental and physical asthenia (MFI- questionnaire 20) and qualities of life (questionnaire MOS SF-36).

Results. The results of the treatment made it possible to establish the relief of asthenic syndrome and autonomic disorders against the background of the use of Mexidol. The differences were statistically significant in nature both in comparison with the initial level, and when comparing with the control group (p <0.05). The use of Mexidol was accompanied by a decrease in the severity of complaints and subjective symptoms. The totality of positive effects has led to an increase in indicators characterizing the state of quality of life (p <0.05). Treatment was characterized by good tolerance.

Conclusion. Patients with HIGM have significant emotional, vegetative and asthenic disorders. The use of Mexidol allows you to reduce the severity of these disorders, which gives reason to recommend it to treat such patients.

Keywords: chronic brain ischemia; arterial hypertension; atherosclerosis; cognitive disorders; vegetative disorders; asthenia; Mexidol; Mexol Forte 250.

Oxidative stress in the pathogenesis of cerebral stroke and its correction

Authors:
M.Yu. Martynov 1.2 , M.V. Zhuravleva 3.4 , N.S. Vasyukova 5 , E.V. Kuznetsova 6 , TR Kameneva 7

1FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;

2FSBI "Federal Center for Brain and Neurotechnology" of the Federal Medical and Biological Agency of Russia, Moscow, Russia;

3FSBI “Scientific Center for Expertise of Medical Application” of the Ministry of Health of Russia, Moscow, Russia;

4FGAOU in "First Moscow State Medical University named after THEM. Sechenov ”of the Ministry of Health of Russia (Sechenov University), Moscow, Russia;

5FGBNU "Federal Scientific Center-the All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Scriabin and Ya.R. Kovalenko of the Russian Academy of Sciences ”, Moscow, Russia;

6GBU "Research Institute of Health and Medical Management" of the Department of Health of Moscow, Moscow, Russia;

7GBUZ "City Clinical Hospital named after M.P. Konchalovsky "Department of Health of Moscow, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 1

Summary:
the value of oxidative stress (OS) in the pathogenesis of ischemic (AI) and hemorrhagic (gi) stroke is considered. The role of OS in the development of programmable cell death, an increase in the permeability of the hematoencephalic barrier, the activation of astro- and microglia, and local inflammation is shown. The issues of neuro and cytoprotheiation and their broadcasting into clinical practice are considered. Examples of experimental and clinical studies show the effectiveness of the continued administration of a multimodal neurocytoprotector with an antioxidant effect - ethylmethydlhydroxypyridine of succinate (Mexidol) in the acute and early recovery periods of AI and GI.

Keywords: stroke, reperfusion, oxidative stress, programmable cell death, apoptosis, ferroptosis, hemoglobin, neuroprotection, ethylmethylhydroxypirinate, mexidol.

The results of clinical studies of the effectiveness and safety of the use of ethylmethylhydroxypyridine of succinate in patients with chronic brain ischemia

Authors:
M.V. Zhuravleva 1.2 , P.R. Kamchatnov 3 , N.S. Vasyukova 4 , V.V. Arkhipov 1 , E.V. Kuznetsova 5 , TR Kameneva 6 , S.Yu. Serebrova 1.2

1 FSBI “Scientific Center for Expertise of Medical Application” of the Ministry of Health of Russia, Moscow, Russia;
2 FGAOU VO "First Moscow State Medical University named after THEM. Sechenov »Ministry of Health of Russia (Sechenov University), Moscow, Russia;
3 FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia;
4 FGBNU "Federal Scientific Center-All-Russian Scientific Research Institute of Experimental Veterinary Medicine named after K.I. Scriabin and Ya.R. Kovalenko of the Russian Academy of Sciences ”, Moscow, Russia;
5 GBU "Research Institute for the Organization of Health and Medical Management" of the Moscow Department of Health, Moscow, Russia;
6 GBUZ "City Clinical Hospital named after M.P. Konchalovsky "Department of Health of Moscow, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 11

Summary:
chronic brain ischemia (Khim) - a common syndrome, which in the absence of adequate therapy is characterized by a progressive course, an increase in cognitive, emotional, motor and other disorders, which ultimately lead to persistent disability of the patient. In the treatment of patients with chemicals, the use of drugs with a multimodal neuroprotective effect is indicated. The results of an analysis of a series of clinical studies of Mexidol and Mexidol Forte in patients with chemicals are given. The effects of the drug are considered in relation to cognitive, emotional, asthenic, vegetative and other manifestations of chemical. The conclusion is drawn about the appropriateness of the consistent use of Mexidol and Mexidol Forte in such patients.

Key words: chronic brain ischemia, cognitive disorders, emotional disorders, mexidol, treatment.

Safety Mexidol® (ethylmethylhydroxypyridine of succinate) in adult patients of different age groups

Authors:
E.A. Ushkalova 1 , S.K. Zyryanov 1.2 , O.I. Buttranova 1

1 FGAOU VO “Russian University of Friendship of Peoples”
2 GBUZ “City Clinical Hospital No. 24 of the Department of Health of the city of Moscow”

Place of publication:
neurology, neuropsychiatry, psychosomatics. 2022

Summary:
To reduce the risk of developing unwanted phenomena and increasing the adherence of elderly patients, it is recommended to limit the total number of drugs prescribed by him as much as possible, using one drug to treat two or more pathologies if possible. LS, which meets the criteria for the use of elderly patients and/or patients with comorbidity, includes the original Russian drug Mexidol ® (ethylmethylhydroxypyridine succinate), which has multimodal mechanism of action and has multiple pharmacological effects. In order to study the safety of Mexidol in comparison with placebo in patients with chronic brain ischemia of different age groups, an aposteric analysis of the international multicenter randomized double -centered clamped placebo -controlled memo with adaptive design on evaluating the effectiveness and safety of sequential therapy Mexidol ® solution for intravenous and intramuscular administration, 50 MG/ml (NPK LLC Pharmasoft, Russia) and Mexidol ® Fort 250 tablets covered with a film shell, 250 mg (NPK LLC Pharmasoft, Russia) in patients with chronic brain ischemia) with the participation of 318 patients aged 40 to 90 years old. The comparable safety and tolerance of Mexidol with middle and elderly persons with chronic brain ischemia, including patients older than 75 years, has been demonstrated. Key words: adult patients of different age groups; elderly; Memo study; Mexidol ® ; Mexidol ® Fort 250; ethylmethylhydroxypyridine succinate; safety.

Hypoxia and oxidant stress with cerebrovascular failure and effective ways to correct them

Authors:

FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2022, T. 122, No. 8

Summary:
Cerebrovascular diseases (CVP) are one of the most common causes of the development of cognitive impairment. The occurrence of CVP is associated with the main factors of cardiovascular risk, leading to the development of hypoxia, oxidative stress, mitochondrial and endothelial dysfunction and, ultimately, apoptosis, the formation of degenerative changes in the brain. The most important mechanisms for the development of CVP are hypoxia and oxidative stress, which indicates the need to use agents with antihyplance and antioxidant activity. Such drugs include Mexidol (ethylmethylhydroxypyridine succinate). Mexol directly affects the pathogenetic factors of the formation of ischemic-hypoxic brain damage, and has high clinical efficiency in the treatment of various forms of CVP.

Key words: chronic cerebrovascular failure, hypoxia, oxidative stress, vascular cognitive disorders, endothelial dysfunction, Mexidol.

Cognitive disorders diagnostic algorithm in outpatient practice

Authors:
E.A. Mkhitaryan, M.A. ATTIC

Place of publication:
New therapeutic journal "Non Nocera", April/May 2022

Summary:
Diagnostics of cognitive disorders (KR) - an integral part of the work of primary doctors working with older persons. KR - an extremely heterogeneous group of conditions not only in gravity, but also by etiology. According to gravity, dementia (severe KR) and non -seal disorders, which are often the prodromal stage of dementia, are distinguished. According to etiology, the most frequent causes of the Kyrgyz Republic in the elderly are neurodegenerative (Alzheimer's disease, a disease of diffuse Taurus Levy) and vascular diseases of the brain, as well as their combination.

Study of the effectiveness and safety of the sequential use of Mexidol and Mexidol Forte 250 in the treatment of patients with acute ischemic stroke

Authors:
S.M. Karpov 1 , M.Yu. Morozova 2 , K.A. Muravyov 2 , I.A. Prisilova 1 , F.S. Kantemirova 3

1 FGOU VO "Stavropol State Medical University" of the Ministry of Health of Russia, Stavropol, Russia;
2 MBUZ "City Clinical Hospital No. 3", Stavropol, Russia;
3 Institute "Medical Academy named after S.I. Georgievsky "FGAOU in" Crimean Federal University named after V.I. Vernadsky ", Simferopol, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 3, Issue. 2

Summary:
Purpose of the study. To evaluate the effectiveness of the use of Mexidol to restore cognitive functions in patients after an ischemic stroke (AI).

Material and methods. 70 patients with acute AI were examined, who were randomized in two groups by random sample; The 1st group amounted to 40 patients (28 men, 12 women), who, against the background of the main standard therapy for 14 days, received Mexidol in/in a drop of 500 mg/day with a further oral administration of Mexidol Forte 750 mg/day for 60 days . The 2nd group included 30 patients (21 men, 9 women), who were carried out only standard therapy.

Results. The initial indicators in the MOCA and MMSE scales did not differ in two groups. Repeated testing showed that the improvement on these scales was statistically more significant in the 1st group. An analysis of the indicators of the caused P300 potential confirmed a more pronounced positive dynamics in the 1st group (p <0.01).

Conclusion. The use of consistent therapy with Mexidol is accompanied by a more complete restoration of cognitive functions in patients who have suffered AI.

Keywords: stroke, acute cerebrovascular disorders, cognitive disorders, Mexidol, Mexidol Fort 250.

COVID-19-SSSOCIETED STROKE

Authors:

IA Shchukin, 1 MS Fidler, 1 IA Koltsov, 1 and A. Yu. Suvorov2

Translated from Zhurnal Nevrologi I Psikhiatrii Imeni SS Korsakova, Vol. 121, no. 12, ISS. 2, pp. 69–76,
December 2021. Original Article Submitted December 20, 2021. Accepted December 22, 2021.

Place of publication:
Neuroscience and Behavioral Physiology, Vol. 52, no. 5, June, 2022

Summary:
The Covid-19 Pandemic Has Had Signifi Cantl Uences on the Incidence of Acute Cerebrovascular and the Structure of Mortaly. SARS-COV-2 Increases The Risks of Developing Both Ischemic and Hemorrhagic Stroke. The Key Pathogenetic Eleement Underlying the Development of Cerebral Stroke in Covid-19 Consists of Impairments to the Operation of Angotensin 2 Receeptors, Which Are Accompaned Accumulation of Excess Quantities of Angiotensin 2, Endothelial Dysfunction, Hypercoagulation, Overproduction of Proin Flamatory Cytokines, and An an An an An an An an An an An an An an An an An an An an An an An an An an An an An an An an An An An An An Ana Oxidive Storm. In Patients with Stroke and Covid-19, Lesion Severity is Associated with Dual Mechanisms of Ischemia-Systemic and Cerebral. The Possibilites of Medication-Based Correction of Systemic Impairments Associated with Coronavirus Infection and Local Imparamic TO ISCHEMIC Ain Damage, Are Limited. Substances with Antioxidant Activity May Potentially Be Effective in Patients with Stroke and Covid-19. Data from a Number of Clinical Rials Indicate that Mexidol Signifi Cantly Imprings Functional Outcomes in Ischemic Stroke. Use of Mexidol in Patients with Stroke and Covid-19 is Advised . Keywords: Ischemic Stroke, Coronavirus Infection, Angiotensin Receptors, Cytokine Storm, Oxidate Stress, Mexidol.

The effectiveness and safety of therapy of drugs Mexidol and Mexidol Forte 250 in patients with chronic brain ischemia

Author:
L.A. Shchepankevich 1.2 , Yu.A. Nikolaev 1 , E.V. Taneyeva 3 , M.A. Pervuninskaya 1 , M.S. Shchepankevich 1.2

1 FGBNU "Federal Research Center for Fundamental and Transalized Medicine", Novosibirsk, Russia;
2 FSBEI "Novosibirsk State Medical University" of the Ministry of Health of Russia, Novosibirsk, Russia;
3 GBUZ but "State Novosibirsk Regional Clinical Hospital", Novosibirsk, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 10

Summary:
Purpose of the study. Studying the effectiveness and safety of consistent therapy with Mexidol, used intravenously (500 mg 1 time per day) for 14 days, followed by the oral form of Mexidol Fort 250 at a dose of 250 mg 3 times a day for 60 days in elderly patients with Chronic ischemia of the brain (chem) against the background of arterial hypertension and atherosclerosis. Material and methods. An open avenue observation study includes 60 patients with a diagnosis of chemicals confirmed by the results of neuroimaging. All patients underwent an examination with the assessment of neuropsychological status (MOCA Test), the severity of asthenia (scale of MFI-20), emotional state (an alarm and depression scale), motor functions (formalized clinical scale for assessing the motor activity of the elderly thinetti). The effectiveness of the therapy was evaluated according to the quality questionnaire (SF-36). Results. The results of the study showed high efficiency and safety of consistent therapy with Mexidol in relation to the relief of asthenic and emotional disorders, improve the state of cognitive functions, and improve the quality of life of patients. The maximum effect took place after the end of the full course of therapy. The high commitment of patients on the therapy, the low frequency of undesirable phenomena are shown. Conclusion. The consistent use of intravenous administration of Mexidol, followed by the oral administration of the drug Mexidol Forte 250, is an effective and safe way to treat patients with chemicals. Keywords: chronic brain ischemia, arterial hypertension, atherosclerosis, ethylmethylhydroxypirinatin, Mexidol, Mexidol Forte 250, cognitive disorders.

Features of patients with traumatic brain injury

Authors:
M.L. Chukhlovina 1 , A.A. Chukhlovin 2

1 FSBEI "National Medical Research Center named after V.A. Almazova "of the Ministry of Health of Russia, St. Petersburg, Russia;
2 Russian Research Neurosurgical Institute. Prof. A.L. Polenova - branch of FSBEI "National Medical Research Center named after V.A. Almazova "of the Ministry of Health of Russia, St. Petersburg, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova 2021, T. 121, No. 9

Summary:
The review is devoted to the analysis of the characteristics of pathogenesis, diagnosis and therapy of traumatic brain injury (CHMT) from the point of view of a neurologist. The mechanisms of development of damage to the central nervous system, including neuro -sparks and oxidative stress, are considered, in persons carrying the ChMT, the connection of clinical manifestations with the severity of the injury. Particular attention is paid to the description of such consequences of the TSMT as structural pharmacoresistant epilepsy and post -traumatic stress disorder. The data is given that rehabilitation measures at the victims of the Civil Code are difficult and less accessible in the conditions of the Covid-19 pandemic. The need to include antioxidant/antihypoxant Mexidol in the complex CMT therapy was noted. In the conditions of the Covid-19, the role of a neurologist increases in the provision of assistance to victims with the CCT, especially at the outpatient stage, during therapy, and medical rehabilitation. Key words: traumatic brain injury, oxidative stress, structural pharmacoresistant epilepsy, post-traumatic stress disorder, infection SARS-COV-2, Mexidol.

Vascular inflammation based on the development of atherotrombotic stroke

Authors:
A.V. Romanenko, I.P. Amelina, E.Yu. Soloviev

FGAOU in Russian National Research Medical University named after N.I. Pirogov »Ministry of Health of Russia, Moscow, Russia

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 8, Issue. 2

Summary:
atherotrombotic stroke is one of the most frequent subtypes of ischemic cerebrovascular accident, the cause of which is atherosclerosis of the large arteries of the brain or their branches. The results of the latest studies have shown that the atherosclerotic process is based on inflammatory changes in the vascular wall, leading to the initiation of atherosclerosis, endothelial dysfunction, oxidative stress, and redistributing various protein components in the composition of the hematoencephalic barrier. As a result, the progression of the described conditions leads to the manifestation of clinical symptoms and the formation of an acute vascular event. Understanding the molecular components underlying functional disorders and damage to cerebral vessels provides the key to modern therapy strategies, forming the foundation for adequate, pathogenetically substantiated drug correction. In such patients, it should be aimed at normalizing cerebral and central hemodynamics and taking into account neuroplasticity mechanisms. The drug Mexidol (ethylmethylhydroxypyridine succinate) can be considered as one of the pathogenetically reasonable drugs in complex drug therapy for brain ischemia. Keywords: ischemic stroke, atherosclerosis, vascular inflammation, oxidative stress, endothelial dysfunction, ethylmethylhydroxypirine succinate.

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