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Chronic cerebrovascular failure (KHNMK) is the result of cerebral micriangiopathy, most often due to uncontrolled arterial hypertension. At the same time, the brain suffers due to repeated “dumb” heart attacks and/or micro -power without clinical manifestations of stroke and chronic brain ischemia. The main manifestation of a chronic progressive non -navigable vascular brain damage is progressive cognitive disorders with a predominance of insufficient concentration of attention, a decrease in the cognitive activity, a violation of planning and control with the relative preservation of memory.
As a rule, these disorders are combined with changes in the emotional sphere in the form of affective lability and depression. A description of the characteristic clinical case of KHNMK is given, the mechanisms of the formation of neurological symptoms are understood, modern approaches to the management of such patients are stated.

Key words: chronic brain ischemia, discirculatory encephalopathy, vascular cognitive impairment.

The purpose of the study.

To clarify the mechanisms of the anti -stress effect of the antioxidant drug (Mexidol) in patients with chronic brain ischemia (Khim). Material and methods. 67 patients with chemicals, 48 ​​women and 19 men, the average age 48.2 years observed. To assess the state of a multi -level stress system, they studied: the level of anxiety and depression, the degree of vegetative imbalance, adaptive blood reactions and the functional properties of red blood cell membranes, the level of medium mass molecules in the blood plasma. Therapeutic complexes included standard therapy and Mexidol of 500 mg (10 ml) intravenously by a drop of 200 ml of physiological solution 1 time per day for 10 days with the subsequent transition to the oral intake of 1 tablet (125 mg) 3 times a day for 3 months. Results and conclusion. In the group of patients receiving Mexidol, a more pronounced and prolonged positive effect on the clinical symptoms of chemicals was noted. These patients had a persistent decrease in anxiety, a decrease in vegetative imbalance. The dynamics of adaptive blood reactions indicated the activation of the function of the adrenal cortex. There was a decrease in the content of the level of medium mass molecules and the restoration of the sorption capacity of ER Itrocytes. The results indicate a multicomponent multi -level stressful effect of Mexidol in patients with chronic brain ischemia.

Key words: Mexidol, chronic brain ischemia, treatment, stress.

Place of publication:
Journal of Neurology and Psychiatry, 2, 2016

Summary:
The purpose of the study is to determine the effectiveness of Mexidol therapy to optimize the secondary prevention of vascular events through exposure to the indicators of vascular-trombocyte hemostasis and lipid blood spectrum in patients who have suffered ischemic stroke (AI), against the background of type 2 diabetes (SD2). Material and methods. Conducted a study of the content of general cholesterol, low -density lipoproteins, high density lipoproteins, blood -triglycerides in blood serum; The concentrations of the 4-plastic factor (4PF), β-tromboglobulin (βTH) and the villebrand factor in 68 patients with AI and SD2 were determined. Dynamic control of the studied indicators was carried out (1st, 21st day, 3rd and 6th months from the beginning of AI) amid therapy with Mexidol. Results and conclusion. Prolonged Mexidol therapy provides additional opportunities for normalizing the lipid blood spectrum and optimize secondary prevention of vascular events in patients with AI and SD2.

Place of publication:
Journal of Neurology and Psychiatry, 5, 2016

Summary:
Purpose of the study. The study of the influence of the combination of Mexidol and Cerebrolysin as part of complex therapy on the state of the clinical status of patients with chronic brain ischemia (chemical) stage II on an outpatient basis. Material and methods. The study includes 36 patients with a diagnosis of stages II. Against the background of basic therapy, patients received 2 courses of combined therapy with Mexidol and Cerebrolysin for 6 weeks with an interval between courses of 3 months. After each course, the dynamics of patient complaints and objective clinical manifestations were evaluated. After the end of the treatment, the content of 13 chemical elements in the hair is determined by the atomic-emission method. Results and conclusion. Based on the clinical and neurological examination, the therapeutic effectiveness of the appointment of Mexidol and Cerebrolysine as a long neuroprotement in patients with the II stage, which was manifested by a reliable decrease in the severity of all the main symptoms under the influence of the therapy, is shown.

The influence of the nature of the atherosclerotic stenizing lesion on the clinical picture of cognitive impairment (KN) has not been sufficiently studied.

The purpose of the study is to assess the effect of the degree and localization of the atherosclerotic stenosis process on cerebral perfusion and the state of cognitive functions.

Patients and methods. 123 patients were examined (65 men and 58 women) aged 50 to 75 years old, having stenoses of brachiocephalous arteries at least 40%, without arterial hypertension, diabetes mellitus or other systemic vascular pathology. The structural state of the substance of the brain and the state of cerebral blood flow were evaluated using magnetic resonance imaging and magnetic resonance angiography. To determine the changes in the white matter, the P. Scheltens scale et al. The localization and degree of the stenosis process was evaluated by extracronal and transcranial duplex scanning by the method of extracranial and transcranial. Prince was determined using a set of neuropsychological scales. The Hamilton depression was also used.

Ascension and discussion. Most of the brachiocephalous arteries examined against the background of atherosclerosis revealed varying severity of the Prince. The most severe KNs were associated with the defeat of the parietal and frontal lobes. A reliable deterioration of cognitive functions was observed as the percentage of stenosis increases: with stenosis in the carotid system, more severe KNs were observed than with stenosis in the vertebral basin. In addition, in patients with combined stenosis and tandem stenosis, more pronounced KN were noted compared to patients with stenosis of the same artery. It is shown that cerebral atherosclerosis is one of the main risk factors for the development of Prince. The influence of not only degrees is noted, but also to a greater extent localization of stenosis on the occurrence of KN, accompanied by the development of perfusion deficiency in specific vascular pools. Determining the nature of the stenosis process will allow to predict the development of KN in patients with atherosclerosis and choose the appropriate treatment tactics.

Key words: atherosclerosis; stenosis of brachiocephalous arteries; Cognitive disorders.

Place of publication:
Journal of Neurology and Psychiatry, 2, 2015

Summary:
Purpose of the study. Analysis of the effectiveness and safety of the use of Mexidol and its impact on the dynamics of neurological manifestations of the disease, the emotional status and quality of life in patients with chronic brain ischemia (chemical). Material and methods. 45 patients with chemicals received Mexidol of 500 mg iv a drop 1 time per day for 14 days, followed by an oral reception of 500 mg (2 tablets 2 times a day) for 60 days. The comparison group consisted of 30 patients with chemicals, comparable by age, the presence of risk factors and the severity of neurological manifestations that did not accept Mexidol. Patients of both groups received basic therapy, including drugs to achieve the complete correction of their risk factors. Assessed the state of cognitive functions (MMSE questionnaire), motor activity, quality parameters (SF-36). Results. By the end of the study (on the 74th day), patients of the main group compared with the comparison group, the severity of motor activity disorders has significantly reduced, the indicator of the assessment with the recount of utility on the SF-36 scale was normalized, and a reliable improvement of the average indicators of the screening estimate of cognitive functions was noted (MMSE). When analyzing the results of the study, the high efficiency and safety of the treatment of patients with a chemous drug Mexidol was confirmed.

The purpose of the study is to study the emotional status (including Alexitimia, anxiety and depression) in patients with a brain infarction in the basin of the middle cerebral artery on the left in the late recovery period and the development of the method of correcting identified disorders.

Material and methods. The study was attended by 30 patients with a brain infarction in the basin of the middle cerebral artery on the left, the comparison group was 10 patients with chronic brain ischemia.

Results and conclusion. The data obtained demonstrate the dependence of the level of Alexitimia on the neurological deficit, gender, level of anxiety and depression. It was established that the development of brain infarction affects the level of Alexitimia. The presence of Alexitimia in patients with a brain infarction leads to a violation of adequate self -esteem of the physical and mental state, which can complicate the rehabilitation of such patients and requires correction - a combination of pharmacotherapy and psychotherapeutic effects.

Keywords: Alexitimia, brain heart attack, anxiety, depression.

Place of publication:
Journal of Neurology and Psychiatry, 3, 2014

Summary:
The purpose of the study is to analyze the effectiveness of the drug Mexidol in relation to the secondary prevention of ischemic stroke (AI). Material and methods. The results of the treatment of 3400 patients who were divided into 7 groups are analyzed: patients with cryptogenic AI, arterial hypertension, atrial fibrillation, metabolic syndrome, obstructive apnea/sleep hypnome, diabetes mellitus, vasculitis. Assessment of the effectiveness of therapy was based on the absence of repeated AI for 5 years of therapy. Results. Mexidol helps to reduce the frequency of repeated AI in both patients without concomitant pathological conditions, and in patients with arterial hypertension, obstructive apnea/sleep hypnome syndrome, vasculitis, diabetes mellitus, atrial fibrillation and metabolic syndrome. Conclusion. Further studies of the effectiveness of the use of Mexidol as a means of secondary prevention of AI are seemed very promising. Key words: stroke, secondary prevention, Mexidol.

Place of publication:
emergency medical care, 2, 2013

Summary:
114 patients with an isolated severe traumatic brain injury aged 18 to 55 years were examined and treated. The group I includes 61 surviving patient, in the II group-53 patients who died on the 3-and -15th day of the post-traumatic period. Patients of groups I and II received complex intensive therapy in accordance with the current protocols. Fifteen patients (subgroup I) were obtained as part of the complex therapy of Mexidol at a dose of 1200 mg/day for 7-10 days. Against the background of the use of Mexidol, the intensity of the processes of lipoperoxidation was reduced, the power of the cell antioxidant protection system remained at a sufficient level, and the earlier resolution of post -traumatic encephalopathy and the restoration of consciousness were observed. Against the background of treatment with Mexidol, a more favorable course of the early post-traumatic period, a decrease in complications (χ2 = 55.4; p <0.0001)-acute damage syndrome, DIC, acute cardiovascular failure and pneumonia are noted.

Place of publication:
Herald of intensive therapy, 2012, No. 3. Neuroreusterology

Summary:
annually in the world from a traumatic brain injury (ChMT), one and a half million people die, and 2.4 million become disabled. The frequency of the CCT in various regions of Ukraine is from 2.3 to 4.2% per year, and over the past 10 years has almost doubled. Missiles for a severe CCT is 40–70%, and in surviving patients, the full functional restoration of the central nervous system (central nervous system) is relatively rare.

Place of publication:
Pharmacate No. 19 - 2012

Summary:
In a study that included 34 patients, the effectiveness of Mexidol's preparation in the correction of astheno-vegetative disorders was studied in persons who have suffered a mild craniocre trauma (LCHMT) and a concussion of the brain. The use of Mexidol as part of the complex therapy of these disorders made it possible to improve the results of treatment compared to the control group of patients who did not receive Mexidol. It is noted that the prescription of the drug is preferably at an earlier date from the moment of injury. A distinct therapeutic effect was obtained when using Mexidol in a daily dose of 375 mg in a tablet form for 28-30 days in the acute and intermediate periods of the LCCMT. Side effects and complications during therapy were not observed in any group. It is concluded that Mexidol can be used in the complex treatment of LCHMTs, a concussion of the brain and the correction of the post -compliance syndrome.

Place of publication:
Journal of Neurology and Psychiatry, 6, 2012

Summary:
in the structure of cerebrovascular pathology, the stroke occupies a leading place as one of the main causes of mortality and primary disability of the population. In the treatment of a stroke, in the acute period, measures are the measures to correct the impaired functions of the body and maintain the viability of the nervous tissue. In the recovery period, drugs are used that have an activating effect on neurotrophic and reparative processes, and secondary prophylaxis of stroke is carried out. It is known that brain ischemia is a multifactor pathological process that includes a decrease in energy products with a violation of active vehicles through cell membranes, excessive accumulation of excitoxic excitation mediators in brain structures, an increase in ionized calcium in neurons, hyperproduction of free radicals and activation of oxidant stress. To correct these changes, preparations with antihyplance and antioxidant properties are traditionally used, which include Mexidol (2-ethyl-6-methyl-3-hydroxypyridine succinate). Mexidol improves the metabolism of nervous tissue, it is also known that it affects the rheological properties of blood, reduces platelet aggregation, and has a hypolipidemic effect.

Place of publication:
Medical alphabet. Emergency medicine 1/22

Summary:
Heddle-brain injury (ChMT) is one of the main reasons for the disability and death of the population. Moreover, mechanical damage to the central nervous system does not tend to decrease in the structure of diseases and injuries. According to WHO, the frequency of craniocre injury annually increases by 2%. In Russia, about 600,000 people receive a traumatic brain injury annually, of which about 50,000 die and the same number of disabled people (Gusev E.I., 2009). Mortality at a severe CMT, according to various estimates, ranges from 10 to 25%, and with the most severe forms reaches 65-70%. In the vast majority of victims (60%), a decrease in performance and disability (epileptic seizures, encephalopathy, paresis and paralysis, speech disorders and other neurological consequences) are observed as a result of injury.

Place of publication:
Bulletin of experimental biology and medicine, 2012, Appendix 1

Summary:
the use of Mexidol in a basic dose of 100 mg/day intramuscularly for 10 days is effective in the treatment of mild CITs, which is confirmed by positive neurological dynamics. In patients with a severe CCT, it is more advisable to use a 10-day treatment regimen with a mexidol at a dose of 200 mg/day intramuscularly with the subsequent transition to orally in a dose of 0.25 g 2 times a day for 4 weeks. Due to the good tolerance and the possibilities of intramuscular administration, Mexidol is an urgent drug in outpatient practice for the treatment and rehabilitation of patients of different age groups with the CCT.

Place of publication:
Stroke, 18, 2006

Summary:
patients with an ischemic stroke at the age of 45–85 years (51 people) entered the first 24 hours from the onset of the disease were included in the study. Mexidol was introduced at a dose of 300 mg/day 24 patients for 14 days from the beginning of the stroke. The placebo was introduced by 27 patients according to a similar scheme. A reliable advanced dynamics in the regression of neurological disorders on the NIH scale by the 14th day of the disease in the group of patients who received Mexol compared to the placebo group (p <0.05), as well as a reliable functional restoration (the dynamics of the clinical score on the Bartel scale at 21, were identified. -y day; p <0.05) in patients included in the study in the first 6 hours of the disease. The normalization of the functional activity of the brain was established in the treatment of Mexidol, including during acute pharmacological test. The complex of studies of the antioxidant system revealed an increase in the activity of its enzymes (superoxidsmutase, glutathioneperoxidase, glutathioneuctase) with the introduction of Mexidol compared to placebo. When analyzing the enzymes of the respiratory chain of mitochondria, an increase in the activity of succinate dehydrogenase was noted. Thus, a reliable clinical confirmation of the effectiveness of Mexidol was obtained in the acute period of ischemic stroke in the carotid system of an atherotrombotic or cardiembolic pathogenetic type, especially with an early (up to 6 hours) its appointment; The mechanisms of action of the drug (antihypoxic, antioxidant) in clinical conditions are clarified.