Gerasymchuk V. Clinical and pathogenetical features of course of ischemic stroke and optimization of treatment tactics in the early recovery period

Dissertation is dedicated to study of features of dynamic of the neurological deficits, cognitive and emotional disorders in the early recovery period of primary hemispheric atherothrombotic ischemic stroke. Is was found out that patients with left-hemispheric stroke developed higher manifestation degree and incidence of post-stroke cognitive impairment, particularly due to presence of speech disorders, while patients with right-hemispheric stroke had higher incidence and severity of depression, anxiety and apathy. Increased level of neuronal destruction marker neuronspecific enolase over 10 ng/mL in 1 month after ischemic stroke was associated with an increased risk of post-stroke cognitive impairment progression and post-stroke dementia, which can be used as a prognostic criterion of post-stroke cognitive impairment course. In patients in the early recovery period of ischemic stroke intensification of the oxidative stress processes was observed with an increased concentration of oxidative protein modification products and decreased activity of glutathione system enzymes on the background of atherosclerotic lesion of major extra- and intracranial arteries. Results of the study showed that the use of choline alphoscerate and vincamine in patients in the early recovery period of ischemic stroke can provide normalization of energy metabolism by activation of aerobic glycolysis and reduce the intensity of oxidative stress, which promotes reduction of the neuronal destruction degree and hyperactivation of platelet hemostasis, thus contributing to more efficient recovery after the ischemic stroke, reduction of neurological deficits manifestations, cognitive and emotional disorders.