Practical recommendations to establish the correct diagnosis in the presence of the patient's cognitive impairment of different nature and severity based on clinical features and neuroimaging manifestations are given in the article.

Keywords: cognitive impairment, dementia with Lewy bodies, frontotemporal degeneration, progressive supranuclear pulsy, corticobasal degeneration, vascular dementia.

Epilepsy is a brain chronic disorder the main feature of which is recurrent spontaneous unprovoked epileptic attacks. Theses attacks are in the form of seizures, sensor or mental disorders due to excessive hypersynchronous cortical neurons stimulation. According to international epilepsy classification the following types of epilepsy are singled out: by the location (focal and partial) epilepsy and syndromes, generalized epilepsy and syndromes, epilepsy and syndromes with both focal and generalized types, special syndromes. The main cause of epileptic attacks is spontaneous local or generalized instability of cortical neurons membranes connected with inherited or secondary acquired features of metabolism. The epilepsy treatment begins only after the differential diagnostics. According to ILAE recommendations the choice of anti epileptic medications should be based on epilepsy form and type, also medication administration should be evidenced.

Keywords: еpilepsy, epileptic syndromes, epileptic attacks.

Да­ны прак­ти­чес­кие ре­ко­мен­да­ции по ус­та­нов­ле­нию пра­виль­но­го ди­аг­но­за при на­ли­чии у боль­но­го ког­ни­тив­ных на­ру­ше­ний раз­лич­но­го ха­рак­те­ра, а так­же сте­пе­ни вы­ра­жен­нос­ти на ос­но­ва­нии осо­бен­нос­тей кли­ни­чес­ких и ней­ро­ви­зу­а­ли­за­ци­он­ных про­яв­ле­ний.

Keywords: ког­ни­тив­ные на­ру­ше­ния, де­мен­ция с тель­ца­ми Ле­ви, фрон­то­тем­по­раль­ная де­ге­не­ра­ция, прог­рес­си­ру­ю­щий суп­ра­нук­ле­ар­ный па­ра­лич, кор­ти­ко­ба­заль­ная де­ге­не­ра­ция, со­су­дис­тая де­мен­ция.

In the article deals with the current state of the problem of blood-brain barrier and cerebrospinal fluid. The major anatomical and physiological features of the liquor system, changes in cerebrospinal fluid in terms of pathology and their significance for the functioning of the nervous system are described. On the basis of literature data and own research authors highlight important questions of blood-brain barrier's management at experiment.

Keywords: liquor, homeostasis, resorption, filtration, endothelium.

Objective – to research the renin-angiotensin system and polymorphism of angiotensin-converting enzyme (ACE) gene significance for course and progress of acute stroke different types.
Methods and subjects. The examination included 232 patients with acute stroke, in 191 had ischemic and 41 – primary intracranial hemorrhage. All patients were genotyped for the angiotensin-converting enzyme insertion/deletion (I/D) polymorphism by polymerase chain reaction. Angiotensin-converting enzyme activity and angiotensin II level in serum were detected by enzymatic assay.
Results. In acute stroke patients most frequent variant of genotype was DD – in 46.1 %, less frequent – is II – in 14.7 %, heterozygote variant ID – in 39.2 %. Significant differences between DD and II variants of genotype were defined which associated with clinical course of stroke and renin-angiotensin system activity. Genotype DD was the most unfavorable and associated with intense severity of stroke, higher blood pressure at admission that is accompanied by increase angiotensin converting enzyme activity. Patients with who had D-allele demonstrated elevation of serum angiotensin II level and severe carotid artery stenosis. Monozygotic variant genotype II was more favorable and associated with the best neurological function recovery, lower blood pressure that accompanied less renin-angiotensin system activity.
Conclusions. The polymorphism angiotensin-converting enzyme gene is clinically relevant and influences the course of acute stroke.

Keywords: acute stroke, angiotensin-converting enzyme gene polymorphism, angiotensin II, angiotensin-converting enzyme.

Objective – to study cognitive function and follow during twenty months, the dynamics of changes and nature of severity of cognitive deficits in patients after stroke.
Methods and subjects. On the basis of Vascular Neurology Department of the City of Uzhgorod Central Hospital a clinical study on cognitive functioning in patients after stroke was performed. The study involved 88 patients divided in two groups of 44 persons each. The study group included patients who suffered stroke with minimal neurologic deficit verified by CT imaging. The control group consisted of patients with hypertension without history of stroke. The examination of cognitive functions was performed using neuropsychological tests (mini mental state examination, the battery of tests of frontal dysfunction, a special task of completing the Schulte’s tables, 10-word test and clock drawing test) in three stages: at discharge from hospital, in three, six, nine and twelve months after stroke.
Results. In a year following the stroke the results of four tests in the study group patients demonstrated significant cognitive decline compared with the control group.
Conclusions. Cognitive impairment was detected in most patients in a year following the stroke.

Keywords: stroke, cognitive impairment, neuropsychological tests.

На ос­но­ва­нии ана­лиза ли­те­ра­тур­ных ис­точ­ни­ков ав­то­ра­ми обоб­щены дан­ные об эти­о­логии и па­то­фи­зи­о­ло­гии тран­зи­тор­ной гло­баль­ной ам­не­зии. Оп­ре­де­ле­ны ос­нов­ные кли­ни­чес­кие кри­те­рии дан­но­го за­бо­ле­ва­ния и пред­став­лен его ди­аг­нос­ти­чес­кий ал­го­ритм. Про­ве­де­на диф­фе­рен­ци­а­ция тран­зи­тор­ной гло­баль­ной ам­не­зии с дру­ги­ми ко­мор­бид­ны­ми за­бо­ле­ва­ни­я­ми ЦНС. Оце­нена ди­аг­нос­ти­чес­кая ин­фор­ма­тив­ность па­рак­ли­ни­чес­ких и ней­ро­ви­зу­а­ли­за­ци­он­ных ме­то­дов ле­че­ния. Па­то­ге­не­ти­чес­ки обос­но­вано ле­че­ние и про­фи­лак­ти­ка тран­зи­тор­ной гло­баль­ной ам­не­зии.

Keywords: тран­зи­тор­ная гло­баль­ная ам­не­зия.

Objective – to estimate oxidative homeostasis state and detect changes in energy metabolism in irradiated individuals with demyelinating and vascular brain diseases as result of Chоrnobyl catastrophe in the remote period.
Methods and subjects. The biochemical parameters of the oxidative homeostasis and energy metabolism were analyzed in 112 patients aged (50.68 ± 1.14) years old with demyelinating and vascular brain pathology. 56 patients of them were irradiated in dose range (0.53 ± 0.10) Gy during elimination of accident consequences at the Chоrnobyl NPP. Disease differentiation and investigation groups formation was conducted on the basis of clinical, instrumental and laboratory examination, taking into account the presence of the contact with ionizing radiation in anamneses.
Results. Chronic brain diseases of the demyelinating and vascular genesis without ionizing radiation influence differ from each other by activation of lipoperoxidation, protein degradation and blood сatalase activity depletion. The presence of ionizing radiation in anamnesis of demyelinating disease is accompanied by lipid carbonyl and ceruloplasmin increased levels, but in irradiated patients with vascular pathology the inhibition of сatalase activity were observed on the ground of pyruvate level increasing.
Conclusions. The presence of radiation exposure in the pathogenesis of demyelinating and vascular brain disease, which are accompanied by сatalase activity and energy-dependent processes disorders, might be considered as one of the pathogenetic factors of the homeostatic disturbances intensity creating pathobiochemical basis for clinical course deterioration.

Keywords: oxidative stress, demyelination and vascular brain pathology, Chornobyl catastrophe.

Цель — ис­сле­до­вать сос­то­я­ние ког­ни­тив­ных фун­кций у па­ци­ен­тов пос­ле пе­ре­не­сен­но­го моз­го­во­го ин­суль­та и про­вес­ти ди­на­ми­чес­кое наб­лю­де­ние за ха­рак­те­ром и осо­бен­нос­тями их из­ме­не­ний на про­тя­же­нии го­да.
Материалы и методы. На ба­зе от­де­ле­ния со­су­дис­той нев­ро­ло­гии Уж­го­род­ской цен­траль­ной го­род­ской кли­ни­чес­кой боль­ни­цы про­ве­де­но кли­ни­чес­кое ис­сле­до­ва­ние по изу­чению ког­ни­тив­но­го ста­ту­са у боль­ных, пе­ре­нес­ших моз­го­вой ин­сульт. В ис­сле­до­ва­нии при­ня­ли участие 88 боль­ных. В ос­нов­ную груп­пу вош­ли 44 боль­ных, ко­то­рые пе­ре­нес­ли моз­го­вой ин­сульт, ве­ри­фи­ци­ро­ван­ный при по­мо­щи ком­пью­тер­ной то­мог­ра­фи, в кон­троль­ную — 44 па­ци­ен­та с диаг­но­зом «ги­пер­то­ни­чес­кая бо­лезнь», у ко­то­рых в анам­незе не бы­ло моз­го­во­го ин­суль­та. Всем па­ци­ен­там про­во­ди­ли ис­сле­до­ва­ние ког­ни­тив­но­го ста­ту­са при по­мо­щи ней­роп­си­хо­ло­ги­чес­ких тес­тов (крат­кой шка­лы пси­хо­ло­ги­чес­ко­го сос­то­я­ния (MMSE), ба­та­реи тес­тов на лоб­ную дис­фун­кцию, спе­ци­аль­но­го эк­спе­ри­мен­таль­но-пси­хо­ло­ги­чес­ко­го за­да­ния по зап­олне­нию таб­лиц Шуль­те, тес­та 10 слов и тес­та ри­со­ва­ния ча­сов) при вы­пис­ке из ста­ци­о­на­ра пос­ле ос­тро­го слу­чая бо­лез­ни, че­рез 3, 6, 9 и 12 мес.
Ре­зуль­та­ты. Спус­тя год пос­ле пе­ре­не­сен­но­го моз­го­во­го ин­суль­та у па­ци­ен­тов ос­нов­ной груп­пы ре­зуль­та­ты че­ты­рех тес­тов по­ка­за­ли дос­то­вер­ное сни­же­ние ког­ни­тив­но­го ста­ту­са по срав­не­нию с больными кон­троль­ной груп­пы.
Вы­во­ды. Че­рез год пос­ле пе­ре­не­сен­но­го моз­го­во­го ин­суль­та ког­ни­тив­ные на­ру­ше­ния имеют мес­то у боль­шин­ства па­ци­ен­тов.

Keywords: ин­сульт, ког­ни­тив­ные на­ру­ше­ния, ней­роп­си­хо­ло­ги­чес­кие тес­ты.

Objective – to investigate whether elevated depressive symptoms (DS) are associated with: metabolic syndrome (MS), its components and with cognitive status of patients with chronic insufficiency of cerebral circulation (CICC).
Methods and subjects. 102 patients with CICC and MS (64.2 ± 7.3 years) enrolled into the study. Diagnostic evaluation included clinical examination, laboratory tests and instrumental investigation. Cognitive assessment consisted of Mini-Mental State. Psychological status of patients was elucidated by means of Asthenia Status Scale. We assessed severity of depressive symptoms using Hamilton scale.
Results. Using regression analysis we found that out of MS components only BMI was significantly associated with DS severity. We did not observe significant changes of BMI and DS severity in different age groups of MS patients. Mild cognitive impairment was more frequent in MS patients without DS; at the same time light dementia was significantly more often observed in MS patients with DS. Correlation of cognitive impairment and DS severity in patients with MS underlines significant role of MS as a risk factor of development of cognitive impairment and DS in patients with CICC. The severity of asthenia was influenced by DS presence, but not by MS.
Conclusions. Evidenced correlation was found of BMI and DS severity. We did not observe significant changes of BMI and DS severity depending on the age. Intensity of cognitive impairments depends on DS severity in patients with MS.According to our results diagnostic evaluation of patients with MS must include scales that assess depression, because the presence of DS leads to increasing of cognitive impairment severity.

Keywords: depressive symptoms, cognitive impairment, metabolic syndrome.

Цель — изучить ха­рак­тер свя­зи меж­ду деп­ре­ссив­ны­ми рас­строй­ства­ми (ДР) и ме­та­бо­ли­чес­ким син­дро­мом (МС) и его от­дель­ны­ми ком­по­нен­та­ми у больных с дис­цир­ку­ля­тор­ной эн­це­фа­ло­па­ти­ей (ДЭ), а так­же вза­и­мос­вязь меж­ду ДР и сос­то­я­ни­ем ког­ни­тив­ных фун­кций у этих боль­ных.
Ма­те­ри­а­лы и ме­то­ды. В ис­сле­до­ва­ние вклю­чи­ли 102 боль­ных (сред­ний воз­раст — (64,2 ± 7,3) года) с ДЭ и МС. Всем па­ци­ен­там про­ве­де­но кли­ни­ко-нев­ро­ло­ги­чес­кое об­сле­до­ва­ние, об­щие ла­бо­ра­тор­ные тес­ты, ин­стру­мен­таль­ные ис­сле­до­ва­ния. Для оценки ког­ни­тив­ных фун­кций ис­поль­зо­ва­ли MMSE, ис­ход­но­го пси­хо­ло­ги­чес­ко­го сос­то­я­ния боль­ных — шка­лу ас­те­ни­чес­ко­го сос­то­я­ния, тя­жес­ти ДР — шка­лу Га­миль­то­на.
Ре­зуль­та­ты. Рег­рес­си­он­ный анализ вы­я­вил дос­то­вер­ную об­рат­ную связь толь­ко меж­ду ин­дек­сом мас­сы те­ла (ИМТ) и тя­жес­тью ДР. Не об­на­ру­же­но дос­то­вер­ных из­ме­не­ний ИМТ и тя­жес­ти ДР у па­ци­ен­тов с МС с воз­рас­том. Лег­кие ког­ни­тив­ные на­ру­ше­ния (КН) дос­то­вер­но ча­ще вы­яв­ля­ли у боль­ных с МС без ДР, на­чаль­ную де­мен­цию — у па­ци­ен­тов с МС и ДР. Ус­та­нов­лен­ная дос­то­вер­ная связь меж­ду вы­ра­жен­нос­тью КН и сте­пенью тя­жес­ти ДР у боль­ных с МС сви­де­тель­ству­ет о важ­ной ро­ли пос­лед­не­го как фак­то­ра рис­ка раз­ви­тия КН и ДР у па­ци­ен­тов с хро­ни­чес­кой не­дос­та­точ­нос­тью моз­го­во­го кро­во­об­ра­ще­ния. На тя­жесть ас­те­нии у боль­ных вли­я­ло на­ли­чие ДР, а не МС.
Вы­во­ды. Ус­та­нов­ле­на дос­то­вер­ная об­рат­ная связь меж­ду ИМ­Т и тя­жес­тью ДР. Не об­на­ру­же­но дос­то­вер­ных из­ме­не­ний ИМТ и тя­жес­ти ДР у па­ци­ен­тов с МС с воз­рас­том. Ус­та­нов­ле­на дос­то­вер­ная вза­и­мос­вязь меж­ду вы­ра­жен­нос­тью КН и сте­пенью тя­жес­ти ДР у боль­ных с МС. На тя­жесть ас­те­нии вли­я­ло на­ли­чие ДР, а не МС.

Keywords: деп­рес­сив­ные рас­строй­ства, ког­ни­тив­ные на­ру­ше­ния, ме­та­бо­ли­чес­кий син­дром.

Objective – to analyze the rate of Parkinson disease progression according to the side (dominant, subdominant) of motor onset (bradykinesia, tremor, rigidity).
Methods and subjects. 205 consecutive patients with idiopathic Parkinson disease were examined at time of routine clinic visits. The following methods were applied: UPDRS, modified Hoehn—Yahr staging, Schwab—England activities of daily living scale.
Results. There was a more rapid disease progression in Parkinson disease patients who had motor onset on the dominant side of the body (62.26 % cases). Parkinson disease patients who had motor onset on the subdominant side of the body demonstrated more prominent asymmetry of motor symptoms.
Conclusions. In our opinion, the side of motor onset (dominant, subdominant) can be considered and taken into account as a prognostic factor of Parkinson disease progression.

Keywords: Parkinson disease, side of motor onset, disease progression.

Objective – to research features of saccular aneurysm (SA) reruptures after the successful endovascular occlusion.
Methods and subjects. Еndovascular treatment results for 598 patients with CА have been given. Endovascular occlusion efficacy assessment was performed by patients control observation. Possible predictors and recurrent haemorrhage causes have been examined.
Results. 9 recurrent reruptures were found during the subsequent 5 years control period: 5 rebreeding – during the first month after an initial occlusion, 3 – in 2 and 1 – in 5 years, all 9 cases were lethal. All SA initially had been occluded totally. Some predictors were marked as: the total reconstructive occlusion, compact packing of SA cavity, and the absence of recanalization after the rerupture. Some predictors were marked: the total reconstructive occlusion, compact packing of SA cavityand the absence of recanalization after the rerupture. For the main causes we have marked: coil pressure on the SA walls due to compact packing, 3Н-therapy, changing of the correlation CА neck – maternal artery, cervical rupture, lumbar drainage and intracranial pressure differential.
Conclusions. The most repeated hemorrhages take place in the first month after SA initial occlusion – more than 55 % (p < 0.005). The recurring hemorrhages of SА sufficiently in the high percent of cases result in heavy and fatal outcomes (more than 60 %). SA total occlusion can’t guarantee absence of the repeated hemorrhages. Detection of the number of features and possible predictors for the rerupture requires a further, severe investigation.

Keywords: cerebral aneurysm, total occlusion, recurring hemorrhage.

Objective – to set up the more efficient combined method of treatment of spinal vascular malformations and to analyse its efficiency.
Methods and subjects. AVM case series were studied. Spinal vascular malformations in 148 patients were reviewed and classified into intramedullary arteriovenous malformations (AVMs) (juvenile and glomus AVMs), intradural arteriovenous fistulas (AVFs), dural AVFs. Therapeutic alternatives to each type of spinal vascular malformations meant combination of endovascular embolization and following surgery. We analysed the short-term and long-term outcomes.
Results. Most of the juvenile AVMs and the types II and III AVFs were treated by endovascular embolization and following surgery. Other lesions were preferably treated by surgery only. Therapy was consistent and demonstrated the benefit of combined treatment. Specific endovascular embolization with a permanent liquid substance is the method of choice.
Conclusions. Successful treatment in each individual spinal vascular malformation requires correct understanding of the lesion's anatomic location and its angioarchitecture, as well as the limitations of both surgery and endovascular embolization.

Keywords: spinal malformations, arteriovenous malformations, arteriovenous fistulas, treatment, methods.

Цель ра­бо­ты — раз­ра­бо­тать ком­би­ни­ро­ван­ный ме­тод ле­че­ния спи­наль­ных ар­те­риове­ноз­ных маль­фор­ма­ций (АВМ) и оценить его эф­фек­тив­ность.
Материалы и ме­то­ды. Про­а­на­ли­зи­ро­ва­ны се­рии слу­ча­ев спи­наль­ных АВМ, в ко­то­рых при­ме­не­ны ком­би­ни­ро­ван­ные ме­то­ды ле­че­ния. У 148 боль­ных регистрировали такие спи­наль­ные маль­фор­ма­ции: ин­тра­ме­дул­ляр­ные АВМ (гло­мус­ные или юве­нильные), ин­тра­ду­раль­ные и ду­раль­ные ар­те­риове­ноз­ные фис­ту­лы. Ле­че­ние спи­наль­ных АВМ пре­дус­мат­ри­ва­ло эн­до­вас­ку­ляр­ную ок­клю­зию и от­кры­тое мик­ро­хи­рур­ги­чес­кое вме­ша­тель­ство. Изу­чены не­пос­ред­ствен­ные и от­да­лен­ные ре­зуль­та­ты ле­че­ния.
Ре­зуль­та­ты. Боль­шин­ство юве­нильных, ин­тра­ме­дул­ляр­ных АВМ и ин­тра­ду­раль­ных ар­те­риове­ноз­ных фис­тул опе­ри­ро­ваны ком­би­ни­ро­ван­ным ме­то­дом. При иных ти­пах АВМ ис­поль­зо­ва­ли толь­ко мик­ро­хи­рур­ги­чес­кие вме­ша­тель­ства. Вы­яв­ле­на вы­со­кая эф­фек­тив­ность ком­би­ни­ро­ван­но­го вме­ша­тель­ства, уве­ли­чение ра­ди­каль­нос­ти вык­лю­че­ния АВМ, умень­шение объ­е­ма ин­тра­о­пе­ра­ци­он­но­го кро­во­те­че­ния. Сре­ди ме­то­дов эн­до­вас­ку­ляр­ной ок­клю­зии эм­бо­ли­за­ция жид­ки­ми эм­бо­ли­зи­ру­ю­щи­ми ве­щес­тва­ми яв­ля­ет­ся ме­то­дом вы­бо­ра.
Вы­во­ды. Ус­пеш­ное ле­че­ние спи­наль­ных АВМ за­ви­сит не толь­ко от ме­то­да хи­рур­ги­чес­ко­го вме­ша­тель­ства, но и от струк­тур­ных их осо­бен­ностей, ан­ги­о­ар­хи­тек­ту­ры, воз­мож­нос­тей эн­до­вас­ку­ляр­но­го и мик­ро­хи­рур­ги­чес­ко­го ле­че­ния.

Keywords: спинальные маль­фор­ма­ции, ар­те­риове­ноз­ные маль­фор­ма­ции, ар­те­риове­ноз­ные фистулы, лечение, методы.

Objective – to study the electric capacity and functional state of the muscles at norm and in case of pathology.
Methods and subjects. 22 patients with peripheral nervous system impairments (traumatic and inflammatory) and with nervous muscular degenerative diseases were examined. The control group consisted of 15 healthy subjects. The mean age of patients and healthy people participated in the study was 37.2 ± 0.5. In the study there was used MY 6013A with needle (bipolar and monopolar) concentric and surface (skin) electrodes. We suggested using the test to measure the functional state of the muscles during their functional activity which included: a) measuring electric capacity muscles of the muscles before the load; b) measuring electric capacity muscles in 40 seconds after the uninterrupted activity; c) measuring electric capacity after 10 minutes break; d) measuring electric capacity muscles after 2 minutes load.
Results. There article presents electrophysiological features of determination of the muscles electric capacity by means of monopolar and surface (skin) electrodes in normal state and in case of pathology, testing the muscles activity during anaerobic and aerobic loads, determination of the functional and dysfunctional muscles state.
Conclusions. The functional state of the muscles, either their dysfunction in muscle weakness or reduction of muscles strength (paresis), can be evaluated by surface (skin) examination of muscles electric capacity. The determination of electric capacity by monopolar electrodes position is more informative. Anaerobic and aerobic loading test allows to evaluate functional and dysfunctional state of the muscles. In spite of its discussable character this research points out the necessity of further study of electrophysiological processes in muscles and necessity of creating new classes of diagnostic equipment.

Keywords: electric capacity, functional muscles state, testing during anaerobic and aerobic loads.

Objective – to develop reliable and reproducible experimental model of focal cerebral ischemia via permanent monofilament MCA occlusion with blocking collateral flow for subsequent preclinical investigation of methods and sources for pharmacological and surgical treatment of stroke and its consequences.
Methods and subjects. Experiments were performed on 50 rats, divided into 5 groups (each consisted of 10 animals): «sham-operated», control, where Longa’s procedure was employed, experimental № 1 – the same as previous, but using Doccol monofilaments, experimental № 2 – Longa’s procedure with CCA occlusion, experimental № 3 – modified model. Neurological assessment was performed after 24 hours and histological sections were prepared after 72 hours of occlusion.
Results. Animals with modified model of focal cerebral ischemia demonstrated the highest score of neurological deficit and the largest volume of infarction comparing to control and other experimental groups.
Conclusions. Persistent functional impairment and its correlation with morphological changes indicate the advantage of this model over the other models of focal cerebral ischemia and imply its use for preclinical investigation of sources and methods of treatment for patients with ischemic stroke.

Keywords: ischemic stroke, experimental model, focal cerebral ischemia, monofilament occlusion, middle cerebral artery.

The efficacy of choline alfostserate in patients with acute ischemic stroke was studied. Its use has a pronounced efficacy in motor and speech function recovery. An earlier recovery of consciousness and a positive effect on patients' mental activity, productive thinking, memory, and social adjustment in general were defined.

Keywords: stroke, choline alfostserate, efficacy, recovery.

Objective – to study the іpidacrinum impact on motor functions recovery level in patients with IS, their motor activity level, cognitive functions changes dynamic and intensity and prevalence of post stroke depression.
Methods and subjects. 45 patients (22 males and 23 females) underwent the clinical and neurological examination at the period of acute IS of hemispheric localization. Mean age constituted (66.7 ± 1.4) ages. Patients were divided into two groups. The main group consisted of 30 patients (mean age 66.8 ± 1.3) who were treated with daily intramuscular іpidacrinum 0.5 % – 1.0 ml during 1–5 days against the background of traditional therapy, the following 6–10 days the dosage was 1.5 % – 1.0 ml daily, the following 11–40 days іpidacrinum pills (20 mg) three times a day. The control group consisted of 15 patients (7 males and 8 females) who underwent the traditional therapy. The examination included the application of NIHSS и MMSE scales, Shulte tables, Hamilton’s scale and Bartel’s index.
Results. Better dynamic of neurological functions (NIHSS scale) was evidenced in patients from the main group, the difference of the average index concerning the control group was reliable from the 14th days of disease (р < 0.05). The rate of disability in patients from the main group decreased on the 14th days ((82.8 ± 3.0) points) comparing to the control group ((77.5 ± 2.9) points, Bartel’s index р < 0.05). Better dynamic of cognitive functional recovery was evidenced against the background of іpidacrinum therapy, reliable differences were marked on the 14th days following the diseases. The positive depression dynamic was also noted against the background of іpidacrinum therapy, with gradual positive emotional status comparing to control group, where patients demonstrated the worsening of depression on the 14th days. It evidences the worse dynamic of neurological deficit elimination.
Conclusions. Better neurological functions recovery, disability level reduction and positive effect of rehabilitation indicate the efficacy of іpidacrinum therapy. It also positively influence the emotional status of patients: cognitive functional improvement, reduction of prevalence and intensity of depression that impacts positively the patients recovery.

Keywords: ischemic stroke, іpidacrinum, neurological functional recovery.

Objective – to improve the quality of care young patients with cerebral ischemic stroke (CIS), caused by abnormalities of the cerebral arteries (CA) by optimizing the treatment strategy.
Materials and methods. The study involved 120 patients with CIS in the first day of onset of cerebral accident. CA anomalies were detected in 54 (45 %) patients who were further divided into 2 groups according to the ongoing drug therapy. The control group consisted of 25 (46.3 %) patients without anomalies CA, which were comparable to the patients in I group on the severity of the CIS. All patients of the control group received standard treatment. The obtained data were processed statistically.
Results. Patients in I group decline in neurologic symptoms by NIHSS at 7th day was on average 29.6 %, on the 14th – 40.3 %, on 21st – 55.3 %. In II group, decline in neurologic symptoms by NIHSS on the seventh day, averaging 5.4 %, on the 14th – 15.1 %, in the 21st – 21.5 % from baseline. In the control group of patients who received standard treatment showed reductions in neurological symptoms by NIHSS at 7th day – 2.2 %, on the 14th – 6.5 %, in the 21st – 10.9 %. Positive dynamics restore the level of consciousness by GCS in patients in I group observed even on the seventh day of therapy: a clear level – 31.7 % of consciousness, on the 14th day – at 76.7 % and in the twenty-first day – in 96,7 % of patients. In contrast to the control group, where a clear level of consciousness on the seventh day was observed in 21.7 % of cases, on the 14th day – in 58.3 %, on the 21st day – in 78.3 % of cases. Reducing disability for Rankin Scale by 1 point on the 7th and 14th day was observed in 89.2 % of patients in group I. In 75.3 % of patients in the control group on the 7th and 14th day showed a reduction in the degree of disability by 0.5 points.
Conclusions. Patients with abnormalities of the CA noted more severe CIS compared to patients without anomalies. It is proved that the proposed scheme of Citicoline treatment in young patients with CIS, caused by abnormalities of the CA has a good clinical effect.

Keywords: cerebral ischemic stroke, cerebral arterial abnormalities, therapy.

Цель — изучить час­то­ту воз­ник­но­ве­ния раз­ры­вов ме­шот­ча­тых аневризм (МА) пос­ле ус­пеш­ной эн­до­вас­ку­ляр­ной ок­клю­зии.
Ма­те­ри­а­лы и ме­то­ды. Про­а­на­ли­зи­ро­ва­ны ре­зуль­та­ты эн­до­вас­ку­ляр­но­го ле­че­ния 598 боль­ных с МА. Оценку эф­фек­тив­нос­ти эн­до­вас­ку­ляр­ной ок­клю­зии МА про­во­ди­ли с по­мощью кон­троль­но­го наб­лю­де­ния за па­ци­ен­та­ми. Изу­чены воз­мож­ные пре­дик­то­ры и при­чи­ны ре­ци­ди­ви­ру­ю­ще­го кро­во­из­ли­я­ния.
Ре­зуль­та­ты. В те­че­ние 5 лет кон­троль­но­го наб­лю­де­ния вы­яв­ле­но 9 пов­тор­ных кро­во­из­ли­я­ний из то­таль­но ок­клю­зи­ро­ван­ных аневризм: 5 раз­ры­вов — в те­че­ние пер­во­го ме­ся­ца пос­ле ини­ци­альной ок­клю­зии, 3 — че­рез 2 го­да и 1 — че­рез 5 лет. Все 9 слу­ча­ев бы­ли ле­таль­ны­ми. Воз­мож­ные пре­дик­то­ры ре­ци­ди­ви­ру­ю­ще­го кро­во­из­ли­я­ния: то­таль­ная ре­кон­струк­тив­ная ок­клю­зия МА, плот­ная там­по­на­да по­лос­ти МА, от­сут­ствие ре­ка­на­ли­за­ции пос­ле пов­тор­но­го раз­ры­ва. При­чи­на­ми ре­ци­ди­ви­ру­ю­ще­го кро­во­из­ли­я­ния мог­ли быть: «воз­дей­ствие» спи­ра­лей на стен­ки анев­ризмы при плот­ной там­по­на­де МА, 3Н-те­ра­пия, из­ме­не­ние со­от­но­ше­ния шей­ка МА — ма­те­рин­ская ар­те­рия, при­ше­еч­ный раз­рыв анев­ризмы, пос­та­нов­ка люм­баль­но­го дре­на­жа в ос­трый пе­ри­од кро­во­из­ли­я­ния и из­ме­не­ние внут­ри­че­реп­но­го дав­ле­ния.
Вы­во­ды. Боль­шин­ство пов­тор­ных кро­во­из­ли­я­ний про­ис­хо­дит в пер­вый ме­сяц пос­ле ини­ци­альной ок­клю­зии МА — бо­лее 55 % (p < 0,005). Ре­ци­ди­ви­ру­ю­щие раз­ры­вы МА в бо­лее чем 60 % слу­ча­ев при­во­дят к тя­же­лым и фа­таль­ным пос­лед­стви­ям. То­таль­ная ок­клю­зия це­реб­раль­ных аневризм не мо­жет га­ран­ти­ро­вать от­сут­ствие пов­тор­ных кро­во­из­ли­я­ний.

Keywords: ме­шот­ча­тая анев­ризма, то­таль­ная ок­клю­зия, пов­тор­ный раз­рыв.