[Prevention of cognitive impairments in patients after stroke].

Previous studies demonstrated that 78.3%-81.6% of patients after stroke have cognitive impairments. In order to prevent vascular cognitive impairments in patients with stroke after discharge from hospital, we have proposed a comprehensive program of activities.

[The new algorithm for disease management of patients with epilepsy based on genetic research].

We have developed and proposed a new algorithm for treating patients with epilepsy, which takes into account the genetic criteria for the effectiveness of AEDs and provides an opportunity to significantly reduce the time drug-resistance definition, which in turn reduces the time progression epileptohenesis. Therefore, the use of alternative treatments for epilepsy, it is possible before the occurrence of irreversible changes in the patient's central nervous system. Therefore, treatment for this algorithm accelerates the choice of adequate treatment tactics in a particular patient, which promotes safety in society as active and healthy citizens.

[Change of bone tissue in patients with epilepsy].

By rezultats study found the difference in bone density in patients with epilepsy that a long-term (over 3 years) took anticonvulsants and healthy persons of similar age and sex (P < 0.01). Less than 50% of patients with epilepsy had normal bone density, in 41.2% patients revealed osteopenia, and in 10.1%--had pronounced osteoporosis. Understanding and timely diagnosis of metabolic disorders associated with the AEP technique allows neurologists to conduct timely prevention of osteoporosis in this group of patients, waiting for clinical manifestations of violations of bone density.

The Mures-Uzhgorod-Debrecen study: a comparison of hospital stroke services in Central-Eastern Europe.

Stroke mortality is extremely high in Central-Eastern European countries. The high rate of risk factors and differences in health care services might be among the factors resulting in high stroke morbidity and mortality in this region. As only few prospectively collected information are available from this region, we decided to evaluate some characteristics of stroke services in neurological departments of a Romanian, a Ukrainian and a Hungarian city in the framework of the Mures-Uzhgorod-Debrecen comparative epidemiological study. We registered demographic data, the absence or presence of the most important risk factors, and clinical signs on admission and at discharge. We recorded the application of various diagnostic methods, stroke treatment and recommendations for secondary prevention. Follow-up is planned after 30 days and after 1 year. The paper summarizes the methodology of this prospective epidemiological study of stroke patients hospitalized in neurological departments in Târgu Mures, Uzhgorod and Debrecen, three Central-Eastern European cities in Romania, Ukraine and Hungary, respectively.

A population study of stroke in West Ukraine: incidence, stroke services, and 30-day case fatality.

BACKGROUND AND PURPOSE: According to World Health Organization statistics, Ukraine has extremely high stroke mortality. No population-based prospective studies of stroke incidence have been performed yet in this European country with approximately 50 million inhabitants. High reported rates of stroke mortality in official statistics conflict with some locally published incidence data in Ukraine. To obtain accurate data, we evaluated stroke incidence and 30-day case fatality in a prospective population study in the West Ukrainian city of Uzhgorod with a population of 126 000 inhabitants. METHODS: Case certification by neurologists and follow-up at 30 days after stroke for all patients identified by any level of the health service system were performed for a 12-month period. RESULTS: We identified 352 stroke cases. The age-standardized incidence was 341 and 238 of 100 000 and mortality was 83 and 69 of 100 000 with the use of the European or world standard population for standardization. Mean age of stroke patients was 63.4+/-12.5 years. Rate of hospitalization was 66%. Hospitalized patients were >10 years younger than those treated in their homes. The 30-day case fatality rates were 15.4% among hospitalized patients and 36.8% among those treated at home. Overall 30-day case fatality was 23.3%. CONCLUSIONS: Stroke incidence and 30-day case fatality in this West Ukrainian city were similar to those of some West European countries and were much lower than what could be expected from World Health Organization statistics. The relatively low incidence rate seems accurate; because of the organization of local stroke services, it is not probable that a considerable proportion of patients with acute stroke could bypass all levels of the acute care health system. Local health statistics reported a much lower number of stroke cases and stroke deaths than found in our survey; thus, further study is needed to clarify the reason for the discrepancy between local data and the high reported stroke mortality in Ukraine.

[The ultrasonographic confirmation of the role of external carotid artery in blood supply of ischemic lesion in the big cerebral hemisphere]. / Dopplerohrafichne pidtverdzhennia znachenia zovnishn'o]i sonnoï arteriï v krovopostachanni ishemizovannoï pivkuli velykoho mozku.

Using intraoperative monitoring of the blood flow linear speed in a. cerebralis media while total a. carotis interna occlusion in 10 patients the authors have concluded, that the degree of blood flow compensation in a. cerebralis media depends not only on collateral compensation possibilities by the contralateral side and rate of it inclusion, but largely-on a. carotis externa possibility on the lesion side.

[Hyperbaric oxygenation in the comprehensive therapy of young and middle age patients in the acute period after mild craniocerebral trauma]. / Giperbaricheskaia oksigenatsiia v komplekse lecheniia postradavshikh molodogo i srednego vozrasta v ostrom periode posle legkoi cherepno-mozgovoi travmy.

The results of treatment of 107 young and middle aged sufferers with mild craniocerebral trauma have been analysed. The regimen for use of hyperbaric oxygenation contributing to normalization of general cerebral, focal disorders in high nervous and psychic activity, prevention of certain posttraumatic complications has been developed.

[Diagnosis of mild cranio-cerebral injury]. / K diagnostike legkoi cherepno-mozgovoi travmy.

As many as 143 patients with concussion and 79 with contusion of the brain of the mild degree were examined. In concussion, the oral reflex never occurs. Meanwhile Marinesco-Radovici reflex is positive almost in 90%, appearing, however, not earlier than 6 hours after the injury and lasting up to 7-16 days. It should be mentioned that in 53.5%, the reflex is unilateral. The latter fact indicates that in concussion, over half the patients manifest the signs of cortical focal derangement together with general cerebral disseminated minisymptoms, seen throughout 1-2 weeks. In mild contusion of the brain in the acute stage, the oral reflex is detectable in 27% of cases. Marinesco-Radovici reflex appears only by days 2-4 after the contusion. The data obtained are helpful in defining the level, degree of the involvement of brain structures, and dynamics of their reverse development in patients with craniocerebral injury, thereby contributing to adequate differential diagnosis of concussion and contusion of the brain of the mild degree.