[The administration of neurocytoprotectors in a rat model of experimental spinal cord ischemia]. / Primenenie neirotsitoprotektorov v usloviiakh éksperimental'noi ishemii spinnogo mozga u krys.

AIM: To study an effect of cortexin on functional recovery and morphology of the spinal cord of rats with spinal cord ischemia. MATERIAL AND METHODS: Spinal cord ischemia was achieved by ligation of the infrarenal abdominal aorta in 16 rats stratified into two equal groups: the ligation of infrarenal aorta was performed in the control group, aorta ligation was performed also in the experimental group with preliminary intraperitoneally administration of cortexin in a dose of 0.15 mg/kg 30 min before procedure. Evaluation of neurologic deficit was performed by the Tarlov's scale. Morphological evaluation was made by analyzing the histological sections of the lumbar and sacral cord using the Nissl's method of coloring. Statistical analysis was performed as well. RESULTS AND CONCLUSION: A pronounced and significant effect of cortexin, which was clinically expressed in a decrease in neurological deficit (p=0.0095), morphologically in an increase in the number of normochromic neurons (р=0.01), and a decrease in shrunken neurons (р=0.0001) and shadow cells (р=0.0003), was noted. The results suggest a potential myeloprotective effect of cortexin. The drug can be considered in the context of treatment of vascular myelopathy.

[The biomarkers of cerebral ischemia as a new method for the validation of the efficacy of cytoprotective therapy]. / Biomarkery ishemii golovnogo mozga kak novyi metod dokazatel'stva éffektivnosti neirotsitoprotektorov.

AIM: To study blood plasma concentrations of NR2-peptide in patients with ischemic stroke (IS) to assess its diagnostic value as a biomarker of cerebral ischemia and determine the dynamics of the biomarker during treatment with cortexin. MATERIAL AND METHODS: One hundred and twenty patients, aged from 18 to 70 years, including 36 with transient ischemic attack (TIA) and 84 with IS in the carotid territory (n=70) and vertebral/basilar territory with the Wallenberg-Zakharchenko syndrome (n=14), were enrolled. The National Institute of Health Stroke scale (NIHSS) was used to assess neurological status. Blood plasma concentration of NR2-peptide was measured in all patients at admission and after treatment. All laboratory results were compared with neuroimaging (MRI, CT) data. RESULTS: Concentrations of NR2-peptide detected in all patients were higher than in controls (>1.5 ng/ml), p<0.0001. The direct correlation between NR2-peptide (from 3.38 ng/ml to 15.6 ng/ml) and ischemic lesion (from few to 80 mm) was observed. A decrease in NR2-peptide concentration (from 8.5 to 5,.9 ng/ml, p<0.0001) was noted in patients treated with cortexin after 10-day treatment course. CONCLUSION: NR2-peptide blood assay is a reliable hemotest of brain ischemia. Cortexin has a sufficient therapeutic efficacy.

[Cognitive functions and treatment of their impairment in elderly patients with the vertebrobasilar issufficiensy].

Authors studied impairment of cognitive functions in 180 patients, aged 56-74 years, with chronic blood flow deficiency in the vertebrobasilar territory. Along with neurological examination, we used MRI of the brain and the cervical spine, MRI-angiography, ultrasound Doppler method, EEG, ECG, clinical and biochemical blood testing. Cognitive functions were assessed using standard neuropsychological tests (a word retrieval test, the Mini-Mental State Examination, the Frontal Assessment battery, the Schulte test, the Landolt test, Wechsler tests, the Wisconsin Card Sorting Test and others). Neuropsychological performance was assessed before and after treatment with cavinton (25 mg intravenous during 10 days and then 10 mg 3 times daily during 3 months). The treatment improved cognitive function and the effect remained for more than 3 months.

[Spinal stroke in the acute myeloblast leucosis].

Data of literature on the frequency of the nervous system lesions in different variants of leucosis are analyzed. A case of a man with petechial skin rash and bruises on the body, gingival hemorrhage and general sickness is described in details. The hematologic tests revealed acute myeloblast leucosis. A lumbar puncture revealed blood in the cerebrospinal fluid and MRI showed an epidural hematoma in lumbar segments 3 and 4. At this level, the hematoma compressed the dural bag and roots of the horse tail with accompanying vessels (the radicular medullar artery and large radicular veins). A paracentetic removal of the hematoma with the decompression of spinal roots was carried out. The blasts in the cerebrospinal fluid and symptoms of the left facial nerve lesion allowed to diagnose neuroleucosis. This case presented the mixed pathogenesis of myeloischemia. The epidural hematoma compressed not only the roots of the horse tail but the accompanying vessels (arteries and veins). The venous outflow obstruction along radicular veins worsened the microcirculation in the cross-sectional area of the spinal cord. Complex polychemotherapy in the combination with neuroprotectors (cortexin, gliatiline), antiaggregants and vitamins is recommended.