Expert commentary

Announcement:

Schukin Ivan Alexandrovich - candidate of medical sciences, associate professor of the Department of Neurology of the Russian State Medical University, answers the main questions about the drug Mexol®. Why is Mexidol® so widely prescribed and popular among doctors and patients? What pharmacological and clinical effects does it have? What is the evidence base and methods of using the drug Mexidol®? Let's figure it out!

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The ischemic process of the heart muscle is the pathogenetic basis of such common diseases as acute myocardial infarction, stable and unstable angina pectoris. An acute or chronic decrease in blood supply to tissues and organs leads to hypoxia and, as a result, energy deficiency, oxidative stress, which may occur irreversible changes in the cell and its death. Understanding the mechanisms of the formation of free radicals became the foundation for creating the concept of combating tissue ischemia and developing a unique domestic drug. Mexidol® is the achievement of the Institute of Pharmacology of the Russian Academy of Medical Sciences. The drug is a combination of two functionally related compounds-3-oxypyridine and succinate. The main pharmacological effects of the drug Mexidol® include antioxidant, antihypoxic and membrane -stabilizing. For many years of clinical use, Mexidol ® has received recognition from the medical community and is rightfully considered the standard of antioxidant cardio and neurocytoprotexts.

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Evidence medicine is the principle of clinical practice, which is based on the results of randomized controlled studies, and not individual opinions and ideas of a particular doctor. A randomized controlled study is a method of a scientific and practical medical experiment, in which the studied are randomly divided into groups: some patients fall into an experimental-the main group (for example, therapeutic), while others-into the control (for example, into a group of placebo). Clinical recommendations are currently developed and continued to be developed, which are based on the evidence base and the result of many studies. They help to determine which drug or treatment method is effective in each case. One of the drugs that meet the requirements of evidence -based medicine, and which is included in clinical recommendations in the treatment of a stroke, is Mexidol ^® . The important effects of the drug include antioxidant, antihypoxic and membrane -stabilizing

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Original drugs or analogues, what to choose? Why is it worth using the original Mexidol®, not generics? In this video, we will discuss the advantages of the original drug over analogues.

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Mexidol® is an original drug, that is, an innovator in his international unauthorized name (MNN segment). It is the first time a synthesized active molecule, which has passed a full cycle of preclinical and clinical studies that proved the effectiveness of Mexidol . Mexidol is based on two related and functionally significant compounds: 2-ethyl-6-methyl-3-hydroxypyridine and succinate. The combination of these components determines the multimodal properties and a wide range of pharmacological effects of the drug Mexidol ® .

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There are many terms in the literature to describe a combined pathology. However, the key difference is the presence of a pathogenetic connection between diseases. If several diseases are pathogenetically interconnected, then this is comorbidity. With polymorbidity, the disease can be both pathogenetically or not related - this is a broader concept. It is very important to avoid polypragmasis in the therapy of comborbid patients, for this we need to optimize the drug therapy scheme, as well as the use of multimodal drugs. 

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It was previously believed that rehabilitation after a stroke should be delayed for several days or weeks in order not to harm the patient. But recent studies have shown that rehabilitation must begin from the first hours in order to avoid severe complications, such as non -class syndrome, muscle spasticism, pain syndromes, psychoemotional and cognitive disorders. Rehabilitation is based on two principles - a multidisciplinary approach to the consequences of a stroke and timely medical support in order to form adequate intersneal ties - one of the main criteria of neuroplasticity.

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The consequences and complications of stroke can be much more dangerous than the stroke itself, so it is important to provide patients with qualified and timely assistance. One of the main factors of successful rehabilitation after a stroke is its early timely beginning, including drug therapy using neurocytoprotective drugs. After a stroke, Mexidol® helps to improve cerebral metabolism, microcirculation, rheological properties of blood, reduces platelet aggregation, has a hypolipidemic effect.

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During the pandemic Covid-19, the mortality of the stroke increased. The development of a stroke in patients with Covid-19 may be associated with various risk factors such as arterial hypertension and atherosclerosis. The virus can also lead to a cytokine storm and a systemic inflammatory response, which contributes to the development of ischemic stroke. Hemorrhagic stroke is more often associated with Covid-associated coagulopathy and erythrocyte hemolysis. Patients with a stroke who suffered Covid-19 often need constant help in everyday life. The structure of assistance to these patients has not changed, but new clinical methods were developed to conduct these patients. The intake of Mexidol® after coronavirus has the following effects: membrane, antihypoxic, antioxidant, etc. Read more about the effects, as well as taking the drug Mexidol® after a stroke and therapy after Covid-19 in our video.

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Medicine is an area that is constantly changing and developing. What was evidence 10 or 15 years ago may not be so relevant today. Requirements for confirmation of the effectiveness and safety of treatment methods, including pharmacotherapy, according to the principles of evidence -based medicine, become more and more strict. We need research that meet certain standards and are carried out on a large number of patients. The proof of the vascular nature of cognitive disorders, treatment protocols and drugs should be based on international-recognized criteria. Based on these criteria, the results of the study of the drug Mexidol® for the effectiveness of chronic brain ischemia are presented.

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Mexidol ® is a well -known drug with proven effectiveness, which with prolonged therapy helps patients return to active life. In the study of the drug Mexidol® Epica, a clinical assessment of the effectiveness and safety of the drug in patients with ischemic stroke was carried out.

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Age is a relative concept. In the last century, the age of 60 years seemed already deep old age. Currently, patients are 70+, even 80+, is not uncommon at the doctor. Cognitive disorders can be a sign of serious diseases and require attention from the doctor. Diagnosis of cognitive disorders should begin in the early stages . Mexidol® in old age is an effective and safe drug. The video presents diagnostic methods and the principles of cognitive disorders in patients are disclosed.

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It is impossible to prevent a traumatic brain injury. Moreover, the incidence remains very high. A frequent complication after a traumatic brain injury is postcommunication syndrome. Most often, such patients complain of a decrease in concentration of attention, as well as a violation of memory. The use of neurocytoprotectors, as one of the most promising groups of drugs for the treatment of neurological diseases, allows you to effectively support patients with traumatic brain injury. Mexidol®, with traumatic brain injury, stops oxidative stress and helps to normalize the metabolism of the brain.

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Proper nutrition and mental loads are the key to maintaining brain activity. Often we ask ourselves - “How to preserve our mental abilities throughout life?” On the one hand, there are people who need notes and the help of others, so as not to forget the simplest things. On the other hand, there are those who, even in a very old age, have excellent memory and clear thinking without any difficulties. So is it possible to maintain sharpness of the mind throughout life? Certainly! To do this, you need to fulfill certain rules and train your brain. In this video, we have collected useful tips and practical recommendations for preserving and improving memory, intelligence and concentration, as well as answers to questions on the use of Mexidol®.

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At the moment, it is proved that the main symptom of chronic brain ischemia is cognitive disorders. This symptom is the main one for both the doctor and the patient. For the patient, because it is cognitive disorders that worsen the quality of life, but for the doctor, because this is the main guideline in the diagnosis. As pathogenetic therapy, Mexidol® is often recommended. Mexidol® has an anti -amnestic effect for memory and attention and has a pronounced ability to improve the processes of higher nervous activity. The effectiveness of the drug with brain ischemia, cognitive disorders, anxiety disorders, etc. has been proved.

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Memory disorders are a common problem of elderly people. Often such disorders are associated with cerebrovascular damage to the brain and concomitant diseases. Patients not only lose the ability to remember information, but also experience anxiety, decreased mood and other symptoms. In this video, we will talk about the causes of memory impairment, as well as how to choose the right drug for therapy, why Mexidol® has a pronounced ability to improve memorization processes, how Mexidol® acts with depression.

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Chronic brain ischemia is a pathology characterized by the inconsistency between the blood supply to the brain tissue and its need for oxygen and nutrients. This condition can occur against the background of atherosclerosis of the vessels of the brain and the stenosis process, against the background of microangiopathy for hypertension. Endothelial dysfunction, neurogenic inflammation, oxidative stress - all this leads to the fact that tissue blood supply is not adequate enough. And it is necessary to choose a drug that would act on all these links of pathogenesis. The drug Mexidol ® is the same drug of choice, because it has an antihypoxic, antioxidant and membraneoprotective effect. It affects vascular risk factors, on hyperglycemia, to arterial hypertension to some extent. The drug has nootropic, anxiolytic and anti -alert effect, normalizes sleep. Also, the drug has a heroome effect. Mexidol ® is a drug of choice for the treatment of chronic brain ischemia.

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Glaucoma is a quiet killer of the optic nerve. The main danger of glaucoma is that often its course is imperceptible to the patient and can progress without impaired intraocular pressure. The second terrible disease is age -related macular degeneration. It affects the center of the macula in the retina responsible for clear vision. Glaucoma and macular degeneration of the retina are two diseases that can lead to blindness. To preserve visual functions in these diseases, it is very important to carry out retinoprotection - retinal protection. Mexidol ®, with glaucoma and other lesions of the optic nerve, showed high efficiency as a neurocytoprotector.

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Glaucoma is a disease in which intraocular pressure increases. This leads to damage to the optic nerve and loss of vision. However, do not despair! Early diagnosis, correct therapy and the use of neurocytoprotexts can prevent vision loss. The role of hypoxia, chemical disorders and oxidative stress in the pathogenesis of glaucoma is undeniable. But what place does neurocytoprotectors occupy in patients with glaucoma? Studies show that neurocytoprotectors play an important role in preserving visual functions in patients with this disease. They help maintain the survival of the ganglion cells of the retina and slow down the degeneration of the optic nerve. One of the trusted neurocytoprotectors is Mexidol®. Studies of the drug Mexidol® confirm its high efficiency in the fight against glaucoma and other diseases of the optic nerve.

Announcement:

The main goal of the treatment of glaucoma is to preserve visual functions and quality of life of the patient with an adequate cost of treatment. Neuroprotection is a very important aspect in preserving visual functions in patients with glaucoma. The studies have demonstrated the results of the effectiveness and safety of the drug Mexidol® in patients with primary open-angle glaucoma of the I-III stage.

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About 2 million people per year dies from alcohol. Alcoholism carries not only a violation of the function of the central nervous system, but also metabolic changes in the whole organism. Therefore, in the complex therapy of patients with alcoholic withdrawal, not only drugs affecting the neurotransmitter balance are used, but also drugs of the antioxidant and anti -hyphyxant group. One of the classic examples of such drugs is Mexidol®. This drug significantly improves the overall health of patients, restores their cognitive functions: memory and attention. Mexidol® with a hangover relieves headache, nausea and dizziness.

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Alcoholic withdrawal syndrome - a person’s condition after prolonged use of alcoholic beverages. It is characterized by a neurotransmitter storm and can lead to serious physical and mental disorders. Apistenic syndrome causes complications, such as heart rhythm and cerebral circulation disorders. Therefore, it is important to seek medical help as soon as possible. Early treatment will prevent complications and begin effective treatment. For example, the drug Mexidol® during withdrawal is able to reduce the manifestation of intoxication, stop headaches, reduce the harmful effects of alcohol. A number of studies of the drug confirm its effectiveness and favorable effects.

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The brain is one of the main target organs of arterial hypertension. The most common cerebral symptoms of arterial hypertension should include headaches mainly in the nape area, as a rule, in the morning, dizziness of varying degrees of severity, noise in the ears and visual impairment. Mexidol® is a drug that has an evidence base and is effective for patients with arterial hypertension.

Announcement:

Increased blood pressure is the main factor of high risk of premature death, brain stroke, myocardial infarction and other cardiovascular complications.

The most vulnerable blending organ with arterial hypertension is the brain.

The clinical manifestation of brain damage as an organ-target of arterial hypertension is cognitive impairment-such as impaired memory and attention. Thus, cognitive disorders are due to the manifestation of hypertension. To optimize antihypertensive therapy, in addition to basic drugs, neurometabolic drugs must be included in therapy and it is advisable to choose those that, as part of one tablet, realize several effects. Such a drug is Mexidol ® . It has a membranestabilizing and antioxidant effect, and also improves brain perfusion, which is extremely important for arterial hypertension. Proper basic therapy and the correct additional drug with a multimodal action mechanism provide maximum improvement in cognitive functions, and, therefore, the quality of life of patients.

Announcement:

Hypertension is the main risk factor for the development of hemorrhagic and ischemic stroke. In addition, this is one of the strongest risk factors for the development of cognitive disorders. Neurocytoprotective therapy is a whole direction in neurology, which uses various drugs to protect the brain. How to choose the right neurocytoprotector? It is important to pay attention to its mechanism of action. An ideal drug should have a polymodal effect, that is, to affect various processes associated with brain damage. One of these drugs is Mexidol ® . In this video, experts will talk about the use of Mexidol®, why Mexidol® with hypertension, this is an important level of treatment.

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The syndrome of the vertebral artery, or spa is a serious pathology in which the blood flow in the vertebral artery is disturbed due to various causes (in particular, due to osteochondrosis of the cervical spine), and manifested by dizziness, impaired coordination of movement, double-eye in the eyes, etc. The same brain ischemia (discirculatory encephalopathy), but associated with degenerative diseases in the spine. It is extremely important to prevent the progression of the condition and choose effective comprehensive treatment, including drug and non -human therapy.

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Therapists often encounter such diseases and conditions that are named “vertebral artery syndrome”, “dorsopathy”, “vertebrobasicular failure”. In the clinical picture, a combination of autonomic and ischemic symptoms is observed, which is manifested by dizziness, double in the eyes, and dissection. It is very important to distinguish and share these complaints. In case of suspicion of vertebro-baslar failure, it is necessary to conduct differential diagnosis with other diseases that can lead to pathology of the vertebral artery. To facilitate the well -being of the patient and the normalization of blood circulation, Mexidol® is often prescribed. Mexidol® in dizziness affects multimodally and provides improvement in the quality of life.

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How is aging? What processes are performed at this moment? Science had no answer to these questions for a long time. However, with the advent of the theory of Inflaiming, we approached the explanation of this phenomenon. According to this theory, the aging process and the development of geriatric syndromes are associated with the progression of chronic, aseptic inflammation. This process is aggravated by oxidative stress, which is one of the main causes of inflammation. And here pharmacological and non -pharmacological methods come to the rescue. The drug Mexidol ® was investigated in laboratory tests that showed its ability to extend life. Mexidol® Effect : antioxidant, antihyplance and membranes.

Announcement:

The free-radical theory of aging explains the violation of the balance in pro- and antioxidant systems, which leads to mitochondrial dysfunction and early aging. Experimental studies with animals have shown that Mexidol ® activates mitochondrial functioning processes and eliminates mitochondrial dysfunction. This leads to results such as an increase in the life expectancy of animals and normalizing their behavioral reactions. Accordingly, taking Mexidol® in old age is able to improve the quality and lifespan.

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What is polyprahmasia? The simultaneous use of several drugs for the treatment of a certain disease is called polypragmasia. Unfortunately, such a phenomenon has certain risks: undesirable reactions of the body, complications of treatment and low adherence to patients to therapy. The use of multimodal drugs is one of the possible solutions to the problem of polypragmasis. Such drugs have the ability to affect not only one, but on several causes of the development of the disease. One of these funds is Mexidol®. Mexidol® Efficiency has been proven by many studies, and its effect has multimodal properties.

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Comorbid patient is a patient who is faced with a doctor of almost any specialty. Such patients differ in the presence of several chronic diseases at once. Especially often comorbid patients are found among the elderly. A classic example of such a patient is a patient with metabolic syndrome. It combines several conditions, including arterial hypertension, obesity, dyslipidemia and diabetes. The patient’s brain with metabolic syndrome is especially susceptible to pathological processes. Therefore, one of the main tasks of doctors is the protection of this neuronal structure. Mexidol® often becomes an assistant in solving this problem. The use of Mexidol® for ischemia , hypertension and other diseases contributes to the prevention of complications.

Announcement:

Patients with the diagnosis of COVID-19 require special attention and the multicomponent process of conducting, the basis of which is the timely and adequate use of drug treatment and rehabilitation. Covid-19 can be associated with such lesions of the central and peripheral nervous system as, for example, encephalitis, meningitis, leukoencephalopathy and Guine - Barre syndrome. The quality of the patient’s recovery depends on the correct rehabilitation. Mexidol ® after coronavirus is an integral part of patient therapy with the consequences of a new infection.

Announcement:

Oxidative stress and energy deficiency are the main mechanisms of pathogenesis of neurological disorders after coronaviral infection. Therefore, for patients who have undergone Covid-19, antioxidants, antihypoxants and energy corruption are needed. Mexidol ® is a pathogenetically justified remedy that helps treat neurological disorders. Mexidol® after coronavirus , as a result of the restoration of the energy synthetic function of mitochondria and neutralization of oxidative stress in nervous tissue, reduces the severity of asthenia, improves sleep and cognitive functions. Studies of the drug Mexidol® have shown that it also reduces the symptoms of chronic brain ischemia, improving the quality of life of patients who have undergone coronavirus infection.

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Many adult diseases begin in childhood. Attention deficiency syndrome (ADHD) is a disorder that is characterized by inattention, hyperactivity and impulsiveness and can be caused by various factors, including genetic, perinatal and psychological. In the treatment of ADHD in children, psychological correction, psychotherapy and nootropic drugs are used. One of these drugs with a high security profile is Mexidol ® . In clinical studies, Mexidol ® showed high efficiency and safety in the treatment of children with attention deficiency syndrome, as a result of which an improvement in cognitive functions, antiasthenic effects and normalization of vegetative functions were achieved.

Announcement:

The syndrome of attention deficit and hyperactivity (ADHD) is a common clinical disorder in children and can manifest itself in the form of impaired attention, manifestations of hyperactivity and impulsiveness. ADHD should be differentiated with other conditions, such as behavior disorder, anxiety disorders, separation anxiety, social alarm and others. ADHD has a complex pathogenesis associated with genetic and biological factors. The approach to treatment requires an interdisciplinary assessment and should include safe drugs aimed at reducing oxidant stress and protecting brain cells from free radicals. Drug treatment using the drug Mexidol® showed high effectiveness in the treatment of ADHD in children.

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In the new issue of the Neurology Plus program, Professor Anatoly Ivanovich Fedin and a corresponding member of the Russian Academy of Sciences, Professor Natalya Aleksandrovna Suponeva consider modern approaches to rehabilitation after stroke and prevention of repeated cases, including pharmacological support.

The relevance of the discussion is due to the fact that each 4th stroke is repeated, and 60% of patients become disabled, but early rehabilitation significantly improves the prognosis.

The key aspects of rehabilitation include:

• Early beginning-the first 3-6 months are critical for recovery.
• Multidisciplinary approach - a team of doctors, kinesitherapists, speech therapists and psychologists.
• Technologies: robotic mechanotherapy, transcranial magnetic stimulation, exoskeletons.

The prevention of re -stroke includes control of blood pressure (target values ​​are individual), antitrombotic therapy (aspirin, clopidogrel), statins for hyperlipidemia, anticoagulants for patients with atrial fibrillation.

Conclusion: complex rehabilitation + individual prevention = maximum restoration and reduction in the risk of re -stroke.

Announcement:

As part of the “Interdisciplinary Academy. Neurology” series, a round table was held on current issues of ischemic stroke.

Key topics for discussion:

• Pathogenesis of stroke – the role of oxidative stress, mitochondrial dysfunction and neurodegenerative processes;
• Diagnosis and prognosis – risk factors, severity markers and rehabilitation options;
• Modern approaches to therapy – the effectiveness of neuroprotective strategies, including the use of Mexidol (proven effect on antioxidant protection and restoration of energy metabolism).

Practical conclusions:

• The importance of early diagnosis and prevention: control of blood pressure, diabetes, depression and venous insufficiency;
• Early diagnosis of chronic ischemia is the key to preventing stroke;
• The role of biochemical markers in predicting the course of stroke;
• Optimal treatment regimens to improve patients' quality of life.

Find out how brain biochemistry influences stroke prognosis and which methods are already changing clinical practice today! Watch the full recording of the roundtable to stay up to date!

Announcement:

In the webinar, experts discuss modern approaches to rehabilitation after a stroke and consider such issues as:

• Neuroplasticity – how the brain recovers from damage;
• The role of pharmacotherapy – how Mexidol (ethylmethylhydroxypyridine succinate) improves functional recovery and reduces the effects of ischemia;
• Neglect syndrome - how to recognize and correct it in time;
• Multidisciplinary rehabilitation is a combination of drug and non-drug methods (occupational therapy, exercise therapy, psychocorrection).

Key takeaway: Mexidol is one of the most effective neuroprotectors, confirmed by clinical studies, including improvement of motor functions, cognitive recovery and quality of life of patients.

Although the focus is on antidepressants, it is emphasized that drugs with neuroprotective action (such as Mexidol) also affect BDNF (brain-derived neurotrophic factor), improving recovery.

Watch the full recording for details!

Announcement:

Arterial hypertension (AH) is a global problem, “getting younger” and affecting people regardless of social status. Primary care physicians often face late diagnosis, and patients – consequences: from cognitive impairment to dementia.

Key topics:

• Diagnosis of hypertension: ABPM (daily blood pressure monitoring) is the gold standard;
• Patient profile: obesity, diabetes, stress – “red flags”. Young patients at risk;
• Target organ No. 1 – the brain: how hypertension destroys cognitive functions (memory, attention, speed of thinking) and increases the risk of stroke;
• The role of the therapist: achieving target blood pressure, early screening of cognitive impairment (tests: Montreal Scale, Trail Making Test).

Therapy:

• Basis: ACE inhibitors/sartans + calcium antagonists/diuretics.
• Neuroprotection: Mexidol is a multimodal drug with proven efficacy (MEMO study).

Early diagnosis and a comprehensive approach save the brain and quality of life of patients!

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Key topics for discussion:

Key topics for discussion:

• Relevance of the problem and statistics;
• Definition of biomarkers and their importance;
• Promising biomarkers;
• The future lies in omics technologies (proteomics, metabolomics), which allow the analysis of thousands of molecules for personalized therapy;
• Clinical applications (neuroprotection and targeted therapy).

Biomarkers are the key to accurate diagnosis and personalized treatment of stroke!

Announcement:

As part of the cycle "Interdisciplinary Academy. Neurology" a round table was held dedicated to current issues of arterial hypertension. Experts - Professor Vadim Vitalievich Tyrenko and Professor Evgeniya Viktorovna Ekusheva - analyze the key problem: how arterial hypertension destroys the brain and leads to cognitive impairment.

What you will learn from the video:

• Hidden threats: why “silent” infarctions and leukoaraiosis are detected only by MRI;
• Early Symptoms: How to Recognize Cognitive Impairment Before Dementia Develops;
• Treatment Errors: Why Blood Pressure Control Isn't Enough to Protect the Brain;
• Neuroprotection: clinical data on drugs with proven efficacy (including Mexidol);
• Advice from a cardiologist: which antihypertensive drugs best protect the blood vessels of the brain.

Watch the full analysis with evidence and clinical cases!

Announcement:

The new episode of the program “Dialogue with Experts” discusses the current problem of arterial hypertension (AH) and its impact on the body.

Main topics:

• Hypertension is a global problem, despite the arsenal of drugs.
• Early signs of brain damage in hypertension: cognitive impairment, fatigue, distracted attention.
• Modern methods of diagnosing cognitive disorders (Montreal scale, attention tests).
• "Roadmap" of a patient with arterial hypertension. Criteria for resistant hypertension.
• Treatment strategies: combination treatment, importance of neuroprotection.
• The role of Mexidol in brain protection: results of the MEMO study, safety and efficacy.
• An integrated approach: not only pressure control, but also protection of target organs.

Announcement:

In this lecture, Professor Elena Anatolyevna Katunina examines key aspects of post-stroke disorders, including movement disorders (hemiparesis, spasticity, apraxia) and cognitive dysfunctions (dementia, neglect syndrome). The lecturer provides statistics, explains the mechanisms of pathology development and offers rehabilitation methods.

Main topics of the lecture:

• Stroke and its consequences – why do only 10-20% of patients return to their previous lives?
• Movement disorders – from classic hemiparesis to rare syndromes (for example, “alien hand”).
• Cognitive impairment – how does stroke affect memory, attention and thinking?
• Diagnostics and rehabilitation – what tests detect apraxia and neglect syndrome?
• Treatment – the role of neuroprotective therapy (Mexidol) in recovery.

Key takeaway: Stroke is not only an acute episode but also a long-term rehabilitation process that requires a comprehensive approach to motor and cognitive impairment.

Rehabilitation after an insult: what a therapist needs to know

Announcement:

The lecture examines key aspects of post-stroke rehabilitation that are relevant for primary care physicians.

Key points:

• Epidemiology: In Russia, > 130 thousand strokes are registered annually, 90% of which are ischemic. Up to 85% of patients experience movement disorders, speech disorders and cognitive deficits.
• Economic burden: the cost of treating one case reaches 1–1.5 million rubles, including long-term care and loss of ability to work.
• The main risk factors: arterial hypertension, atherosclerosis, diabetes mellitus, obesity and smoking are the key triggers of atherothrombotic and lacunar strokes.

Modern approaches to rehabilitation:

• Three-stage model:
  • Stage 1: Early rehabilitation in hospital (first 21 days).
  • Stage 2: specialized centers (up to 3-6 months).
  • Stage 3: Outpatient observation (up to 12 months).
• The role of drug therapy: the drug Mexidol (ethylmethylhydroxypyridine succinate)
  • Improves the restoration of neurological functions.
  • Reduces the risk of recurrent stroke by 5 times in patients with hypertension.
  • Corrects cognitive and emotional disorders (depression, anxiety).
• Practical recommendations:
  • Scheme of application of Mexidol:
    • 14 days intravenously at 500 mg/day → 2 months orally (Mexidol Forte 250 mg × 3 times a day).
    • Optimally, 2 courses per year.
• The Importance of a Multidisciplinary Approach: Combination of Medication, Physical Rehabilitation and Psychological Support.

Rehabilitation after an insult: what a therapist needs to know