Yakovlieva L. Clinical and pathophysiologic mechanisms of motor and cognitive impairment in patients during the recovery period of stroke, methods of correction

Dissertation is devoted to clinical and pathophysiological mechanisms of motor and cognitive disorders in patients during the recovery period of ischemic stroke, especially neuropsychological changes, hemodynamic, functional brain activity and evoked bioelectric activity, structural changes in the liquor system and brain tissue, depending on the duration of the recovery period of the disease and the predominant their localization, subtypes of ischemic stroke. The defined a role of lipoprotein metabolism disorders and homocysteine in the progression of motor and cognitive disorders after stroke. According to the study 100 patients with ischemic stroke demonstrated that in patients with supratentorial localization of stroke in the clinical picture is dominated by significantly motor-sensory disorders (95,4 %), cerebro syndrome (100 %), mild (49,0 %) and temperate (25,0 %) dementia. Patients with subtentorial localization of stroke in the clinical picture are dominated by significantly vestibular-cerebellar syndrome (97,1 %), mild (23,0 %) and temperate (37,0 %) cognitive decline. Established among the pathogenic mechanisms of intracerebral disorders after stroke is the metabolic changes associated with decreased cerebral blood flow and cerebral electrogenesis, increased atherogenic lipoprotein fractions and serum homocysteine, changes in cerebrospinal fluid system and brain tissue. The determined the dependence between the level of dyslipidemia, hyperhomocysteinemia and degree of severity post-stroke motor and cognitive disorders. The use of lipid-lowering therapy (vabadin), proofreaders homocysteine (milgamma) cytoprotective therapy (cytoflavin) has a positive effect on the course of cognitive and motor disorders, neuropsychological, hemodynamic parameters of the brain, the level of atherogenic lipoproteins and homocysteine. The use of physical therapy methods - magnetic-therapy and dosage Lokomat training on the apparatus for the treatment of patients with the consequences of stroke contributes a speedy recovery neurological function, data neuropsychological, electrophysiological methods of examination. Keywords: motor, cognitive disorders, ischemic stroke, clinical features, EEG, TC DU, DC, stabilography, homocysteine, treatment, rehabilitation.