[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.

[Ways to optimize the treatment of patients with discogenic-venous lumbosacral radiculomyeloischemia].

AIM: Treatment of patients with neurological manifestations of degenerative-dystrophic lesions of the spine must be integrated and optimized from the perspective of pathogenesis. Antiedematous therapy is an important moment that takes into account the development of localized swelling affected the spinal structures. We studied the efficacy of L-lysine aescinat in the treatment of patients with discogenic-venous lumbosacral radiculomyelopathy. MATERIAL AND METHODS: We analyzed the therapeutic efficacy of antitumor therapy with the drug L-lysine aescinat in 40 patients with discogenic-venous lumbosacral radiculomyelopathy in comparison with a control group of 40 patients treated with conventional therapy in a neurological hospital. The age of the patients ranged from 30 to 60 years. In total, there were 36 (45 %) women and 44 (55%) men. Herniated discs were visualized by MRI in all patients, attention was drawn to the condition of radicular veins of the cauda equina. We assessed muscle strength of lumbosacral myotomes, their trophicity and state of segmental-conductor apparatus sensitivity with the quantitative determination of the time of vibration of a tuning fork. RESULTS AND CONCLUSION: The comparison of neurological status dynamics during treatment of inpatients has shown that neurological symptoms reduce more effectively in patients treated with L - lysine aescinat (by 75% during the first 3-5 days) and in a greater number of the patients (77.5% vs 55% in the control group). The authors' experience has shown that venous micro- and macro-circulation disorders play an important role in the pathogenesis of lower lumbar disk hernia. Clinical manifestations of these disorders are segmental and conductive spinal motor disorders in myotomes and sensitivity. Quantitative determination of vibration sensitivity (tuning fork test) is pathognomonic for radiculomyeloischemia. Vein tonics and antiedemics, including L - lysine aescinat as one of the most effective drugs, exert a pathogenetic effect on spondylic and discogenic nervous system disturbances.

[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.