Pogorielov O. Clinical and neurophysiological features of acute ischemic disorders of cerebral circulation (diagnostic, prognosis)

Dissertation is based on examination of 1118 patients suffered from ischemic strokes and transient ischemic attacks. 211 of these patients were examined repeatedly taking part in long-term study. New criteria of exposure and estimation of unfavorable types of the neuronal reacting were proposed based on the study data. Treatment approaches for optimization of cortical and stem structures conditions, neuronal asthenias after stroke were proposed. New property of the CNS was at first described: there is a stable in time individual structure of the evoked cortical response. Typical patterns of the CNS reacting (high reacting and torpid types) were described. Factors that affect the nervous activity in patients suffering from stroke were established. One of these factors is reticular formation dysfunction. The features of this dysfunction in patients with strokes and transient ischemic attacks were described. Main flags of microcirculation disorders which can be independent prognosis factors of ischemic stroke, were established: microaneurisms, local glomerular pathological phenomena, microhaemorrhages. It was shown, that pharmacological treatment effectiveness could be increased by the CNS spontaneous and evoked activity monitoring using activation methods, which have been developed. The effectiveness and safety of non-pharmacological additional non-specific activation of reticular structures and specific methods of neuronal rhythm correction were established.