[The active neuroprotective therapy of acute carotid ischemic stroke of moderate severity]. / Aktivnaia neiroprotektivnaia terapiia ostrogo karotidnogo ishemicheskogo insul'ta srednei stepeni tiazhesti.

Objective. To evaluate the efficacy of neuroprotective therapy in carotid ischemic stroke. Material and methods. An open comparative study of combined neuroprotective therapy in comparison with standard treatment has been carried out in 25 patients with carotid ischemic stroke of moderate severity in the acute period of disease. Patients received cytoflavin, gliatilin and actovegin, along with basic therapy, during 15 days. Patient's state was assessed every 5 days using the NIHSS. The Barthel index was estimated in the 21st day. Results and conclusion. By the end of treatment, the degree of neurological deficit was significantly lower in patients treated with the combination of the neuroprotectors. The better functional rehabilitation to the 21st day and the positive dynamics of inflammation indices and free-radical processes were shown in patients of the main group.

[Headache in autonomic-vascular dystonia]. / Golovnye boli pri vegeto-sosudistoi distonii.

The clinical variants of headaches were observed in 83 patients with autonomic vascular dystonia. The diagnostic table was designed to differentiate between the latter and migraine. Bulbar conjunctiva and retinal microcirculation studies revealed multiple morphological and hemodynamic changes. These were especially marked during painful paroxysms. The substantial increase in red blood cell aggregation rates was observed within the entire headache exacerbation. The data provide grounds for using adrenergic blockers, antiaggregatory and venotonic drugs in these conditions.

[Pathogenetic aspects of ischemic strokes]. / Nekotorye aspekty patogeneza ishemicheskikh insul'tov.

The article presents data on total calibrometry of the vascular bed of the brain in 26 patients who had died of ischemic cerebral stroke. All patients with nonthrombotic ischemic cerebral stroke showed a considerable decrease in the total lumen of the cerebrovascular bed on the side of the ischemic focus with a significant increase in the coefficient of hemispherical asymmetry. In most cases impoverishment of the hemodynamics was related not to occlusive or gross stenosing process of one of the major vessels but rather to nonmanifest narrowing of several vessels in the hemisphere on the involved side. The coefficient of asymmetry in patients with thrombotic cerebral stroke was the minimal which is explained by the fact that even complete thrombosis of one vessel has no serious effect on the total lumen of the vascular bed of the brain. The findings obtained confirm the theory of the involvement of cerebrovascular insufficiency in the genesis of ischemic cerebral strokes as the main pathogenic component in acute disorders of the cerebral circulation.

[Clinico-immunologic parallels in atherosclerotic discirculatory encephalopathy]. / Kliniko-immunologicheskie paralleli pri ateroskleroticheskoi distsirkuliatornoi éntsefalopatii.

For disclosing the character of the immunological reactivity disturbances in atherosclerotic discirculatory encephalopathy the humoral and tissue immunity was examined in 160 patients. Signs of an increase of the hypersensitivity (both immediate and delayed) to local antigens were revealed, these signs correlating with the stage of the encephalopathy development. The changes discovered may be of a diagnostic and prognostic value in chronic forms of vascular encephalopathies.

[Disorders in lipoprotein metabolism indices in cerebral atherosclerosis, their importance for diagnosis and medical-occupational expertise]. / Osobennosti narushenii pokazatelei lipoproteinovogo obmena pri tserebral'nom ateroskleroze, ikh znachenie dlia diagnostiki i vrachebno-trudovoi ékspertizy.

Using a wide complex of biochemical indices 166 patients with cerebral atherosclerosis were examined. It was shown that in this disease regardless of the period of acute stage a deficiency of the brain circulation of physicochemical changes of the serum proteins, lipoproteins and an oppression of the process of cholesterol exterfication precede quantitative accumulation of total cholesterol in the blood, beta-lipoproteins, a decrease of the lecethin level and changes of protein fractions. Heparin treatment along with improvement of the patients' clinical state, indices of general and brain hemodynamics decreased a free cholesterol level, increased the strength of cholesterol and apoprotein relationship and phosphorolipid content in the blood. In the author's opinion one of the leading causes of lipoprotein metabolic disorders in atherosclerosis can be a change of hormonal regulation of the activity in proteins enzymes of the organs and tissues, including the enzymes regulating an oxidation-reduction process in the organism. The significance of the studied indices for diagnosis and medical labour examination is considered.

[Lipoprotein metabolism disorders in hypertension with a cerebral syndrome and their diagnostic value for medico-occupational expertise]. / Osobennosti narushenii lipoproteinovogo obmena pri gipertonicheskoi bolezni s tserebral'nym sindromom i ikh diagnosticheskoe znachenie dlia vrachebno-trudovoi ékspertizy

On the basis of a profound clinico-biochemical study of 182 patients with hypertensive disease the authors established that the development of chronic insufficiency of cerebral circulation in this disorder is accompanied by quantitative and physico-chemical changes in the lipoprotein metabolism. These indices do not change significantly following short sessions of heparinotherpy and comprehensive treatment. Their diagnostical significance for medico-occupational examinations is discussed.

[Cerebral hemodynamics in the acute and remote periods of closed cranio-cerebral trauma]. / Osobennosti tserebral'noi gemodinamiki v ostrom i otdalennom periodakh zakrytoi cherepno-mozgovoi travmy

By using clinical and zonal REG methods the authors examined 204 patients with brain traumas. Such examinations permitted to detect symptoms of a disturbed cerebral vascular tone. In the acute period of a closed brain trauma changes of cerebral hemodynamics were not stable and were nonhomogenous by direction. A differential qualification of the general and cerebral hemodynamics in the remote period of a closed brain trauma permitted to distinguish 4 types of cerebral vascular disorders. The obtained results facilitate an objective assessment of brain traumas and their pathogenetical treatment.

[Coagulation properties of the blood and effectiveness of heparin therapy in patients with the cerebral form of hypertension and atherosclerosis]. / Koaguliatsionnye svoistva krovi i klinicheskaia éffektivnost' lecheniia geparinom bol'nykh tserebral'noi formoi gipertonicheskoi bolezni i ateroskleroza

By means of clinical and instrumental diagnosis the authors displayed a high effectiveness in the preventive treatment of patients with atherosclerosis and hypertensive disease by heparin in the period of remission. At the same time following treatment some patients especially with hypertensive disease revealed a marked activation of the hypercoagulative blood properties which exceeded the intial level. The authors discuss the possible mechanisms of this reaction.