Nasonova T. Diagnostic Criteria and Pharmacological Correction of Cerebral Ischemic Stroke Caused by Metabolic Syndrome (some pathogenic mechanisms, clinical manifestations, diagnosis, treatment and prevention)

The thesis is devoted to the improvement of diagnostic criteria and treatment efficiency of primary ischemic stroke caused by metabolic syndrome. Clinical and instrumental studies of 409 patients have been performed.There has been made a theoretical evidence summary and a new look given at the problem of cerebral ischemic stroke with metabolic syndrome by clarifying the pathogenic characteristics and improving diagnostic criteria based on multivariate clinical and paraclinical research, involving comprehensive definition of clinical, clinic- neurological, neuropsychological, instrumental and laboratory characteristics of the brain condition in acute ischemic stroke and chronic cerebrovascular disease in patients with metabolic syndrome, to improve and optimize the therapeutic management of primary and secondary prevention of ischemic stroke. It has been found out that patients with metabolic syndrome, ischemic strokes are characterized by more severe clinical and functional manifestations, delayed recovery of lost functions and cognitive and psycho-emotional disorders. The above mentioned features were accompanied by neuroimaging markers of cerebral damages: patients' with metabolic syndrome have larger areas of cerebral damages in comparison to those without metabolic syndrome - increased ventricles, reduced cortex thickness of the frontal, temporal lobes and hippocampus index. In the early and late regenerative periods, there were determined the psycho-emotional and cognitive changes that correlate with atrophic changes in the brain. Patients with chronic cerebrovascular diseases who are in the primary risk of ischemic stroke occurring in the presence of metabolic syndrome, were determined to have some clinical, neurological and neuropsychological changes. These changes were accompanied by a decrease in the volume of white matter and cortex of the frontal and temporal lobes as well as hippocampus.