Peculiarities of topical diagnostics in neurology are indicated, main clinical syndromes are determined, examples of justification and formulation of the topical diagnosis are given.

Keywords: topical diagnosis, clinical neurological syndromes.

Changes of frequency and breath rhythm are considered at pathological processes in the central nervous system. The general principles and determination of acute respiratory insufficiency, its classification by anatomical and physiological changes in an organism are presented. Characteristic pathological types of the breath, which emergence can point to localization of defeat of this or that department of the central nervous system, and their predictive value are defined.

Keywords: acute respiratory insufficiency, pathological types of breath, diagnostics of pathological processes in the central nervous system.

Multiple sclerosis (MS) – a chronic progressive autoimmune-inflammatory neurodegenerative disease of the nervous system, the etiology of which is unknown at present. Great importance in the development of MS belongs to vitamin D. Based on the analysis of domestic and foreign literature we have summarized information on the role of vitamin D in causing to MS and its impact on the course of the disease. The results of the major randomized clinical studies on this subject were given.

Keywords: multiple sclerosis, etiology, vitamin D.

Multiple sclerosis (MS) – a chronic progressive autoimmune-inflammatory neurodegenerative disease of the nervous system, the etiology of which is unknown at present. Great importance in the development of MS belongs to vitamin D. Based on the analysis of domestic and foreign literature we have summarized information on the role of vitamin D in causing to MS and its impact on the course of the disease. The results of the major randomized clinical studies on this subject were given.

Keywords: multiple sclerosis, etiology, vitamin D.

Multiple sclerosis (MS) – a chronic progressive autoimmune-inflammatory neurodegenerative disease of the nervous system, the etiology of which is unknown at present. Great importance in the development of MS belongs to vitamin D. Based on the analysis of domestic and foreign literature we have summarized information on the role of vitamin D in causing to MS and its impact on the course of the disease. The results of the major randomized clinical studies on this subject were given.

Keywords: multiple sclerosis, etiology, vitamin D.

Оbjective – to estimate the brain structures functional state during the ischemic stroke early restorative period by means of auditory cognitive evoked potentials P300 and acoustic brainstem evoked potentials.
Methods and subjects. 78 patients who had hemispheric ischemic stroke and 14 practically healthy subjects were under the examination. Functional brain and brainstem structures state were assessed with method of evoked potentials P300 and acoustic brainstem evoked potentials.
Results. It was found that changes of P300 latency did not depend on the lesion focus in patients with mild stage of dependence according to Bartel scale. Patients with moderate stage of dependence had significant changes of P300 on the ischemia focus location, in some patients there were no changes admitted. Changes of acoustic brainstem evoked potentials in all patients proved the concernment of upper stem level of different evidence.
Conclusions. Combined application of evoked potentials, connected with the action, and acoustic brainstem evoked potentials provides with the possibilities of accurate estimation of brain and brainstem structures state in patients in early restoration post stroke period.

Keywords: ischemic stroke, evoked potentials.

Objective – to study the state of cerebral circulation in patients with type 1 diabetes mellitus.
Methods and subjects. 53 patients with type 1 diabetes mellitus (including 23 men, 30 women) were examined. The mean age of patients was 37.8 ± 1.7 years. The control group included 45 people without diabetes mellitus, matched by the age and sex without diabetes mellitus and clinical signs of cerebrovascular pathology. Mean duration of diabetes was 12.0 ± 1.2 years. All patients were on intensified insulin therapy scheme. Investigations were carried out using the extra-and transcranial Doppler ultrasonography for assessing the linear parameters of blood flow and function of the central mechanisms of regulation, using Elegra (Siemens, USA).
Results. As a result of the study the circulation disorders of extra- and intracranial cerebral vessels were revealed, they can cause the development of acute and chronic cerebrovascular disorders in patients.
Conclusions. Decrease in the rate of extracranial blood flow in patients with type 1 diabetes mellitus is significantly lower (p < 0.01) in the common and internal carotid arteries in comparison with a control group. Significantly reduced blood flow velocity in the middle cerebral artery was noticed in patients with type 1 diabetes mellitus comparing to the group of healthy people. The deterioration of the cerebral blood flow may be one of a risk factor for acute and chronic cerebral blood flow disorders in patients with diabetes type 1.

Keywords: type 2 diabetes, stroke, internal carotid artery, middle cerebral artery.

Objective – to study the features of cognitive disorders (CD) in patients with disseminated sclerosis (DS) and to determine their correlation with diffusive cerebral atrophy (DCA) of brain in accordance with MRI data.
Methods and subjects. 60 patients aged from 20 till 65 with DS in the remission stage were under the examination. The first group included 30 patients aged 20–35 years whose DS onset was diagnosed at the age of 24.0 ± 3.1 years; the second group comprised 30 patients at the age of 35–65 years with DS beginning at the age of 43.0 ± 1.5 years. All patients were under the standard neurological examination and had brain MRI.
Results. Neurological examination revealed the presence of DS in patients of both groups. General assessment of cognitive functions by means of MMSE scale was significantly lower in patients of the second group. Under the examination by means of Luria test patients of both group presented disorders in close and long-term reproduction however patients of the second group demonstrated higher rate of disorder. Results of DS and DCA correlation study demonstrated the presence of the correlation in patients of the second group meanwhile it was not noticed in the patients from the first group.
Conclusions. The study revealed that elderly patients have more marked DS according to MMSE scale, Luria test and clock drawing test. It confirms the correlation of brain DCA and DS in elderly patients.

Keywords: disseminated sclerosis, cognitive disorders, diffusive cerebral atrophy.

Objective – to evaluate the effects of hydrochloride memantin (Mema) as pathogenetically significant regulator of cognitive impairments in patients with Parkinson's disease (PD) against a background of basic therapy.
Methods and subjects. 26 patients, aged from 49 to 74 years, with PD, stage 1.5–3.0 by Hoehn–Yahr, were examined. The course treatment with hydrochloride memantin, 5 mg in the morning and 5 mg in the evening, lasted 3 months.
Results. The use of hydrochloride memantin (Mema) for PD patients was effective and safe. As a result, the intensity of cognitive impairments decreased significantly. In particular, we observed less intensive neuropsychological manifestations of lobe dysfunction (improvement of the ability for generalization, increase of associative reading), stability of memory trace to interference, improvement of attention and visual-spatial function.

Keywords: Parkinson's disease, cognitive impairments, NMDA-receptors, memantin.

Objective – to evaluate the effects of hydrochloride memantin (Mema) as pathogenetically significant regulator of cognitive impairments in patients with Parkinson's disease (PD) against a background of basic therapy.
Methods and subjects. 26 patients, aged from 49 to 74 years, with PD, stage 1.5–3.0 by Hoehn–Yahr, were examined. The course treatment with hydrochloride memantin, 5 mg in the morning and 5 mg in the evening, lasted 3 months.
Results. The use of hydrochloride memantin (Mema) for PD patients was effective and safe. As a result, the intensity of cognitive impairments decreased significantly. In particular, we observed less intensive neuropsychological manifestations of lobe dysfunction (improvement of the ability for generalization, increase of associative reading), stability of memory trace to interference, improvement of attention and visual-spatial function.

Keywords: Parkinson's disease, cognitive impairments, NMDA-receptors, memantin.

Objective – to analyze demographic and clinical data and anatomical features (localization and structure) of secular aneurysms located in the anterior cerebral and anterior communicating arteries, which were coiled.
Methods and subjects. 323 patients with 323 aneurysms had 347 endovascular operations. All aneurysms were delimited on disrupted (312 (96.5 %) patients) and unruptured (11 (3.5 %) patients) groups. 233 (72 %) patients with unruptured aneurysms were operated in acute period, 79 (24.5 %) patients were operated in a cold period.
Results. Initial aneurysms manifested with spontaneous intracranial hemorrhage – 312 (96.6 %), 2 (0.6 %) with unruptured aneurysms with mass-effect and 9 (2.8 %) cold aneurysms – as a waif. Quality of life by Rankin scale after the initial operation: 0 grade – 81 (25.1 %), 1 grade – 91 (28.2 %), 2 grade – 82 (25.4 %), 3 grade – 35 (10.7 %), 4 grade – 17 (5.3 %), 5 grade – nobody, 6 grade – 17 (5.3 %) lethal outcome.
Conclusions. Еndovascular operations are the reliable, little traumatic and effective method of aneurysms treatment. This method allows most of patients to return to the normal life style after treatment: only 5.3 % of lethal cases and 5.3 % cases of disability were indicated.

Keywords: secular aneurysm, anterior cerebral artery, anterior communicating artery, endovascular occlusion.

Objective – to study the efficiency of Gliatilin medication on vegetative reactions, cognitive functions in patients of different age groups with chronic brain circulation impairment of different disease genesis.
Methods and subjects. 140 patients aged from 60–80 years were examined. They underwent clinical, neurological and neuropsychological examination, arterial pressure monitoring, EKG, ultrasound imaging, brain MRI. The attention stability, workability changes, audio and speech memory were examined. Patient of the main group (n = 72) received Giatilin as a component of complex hypotensive and symptomatic therapy (first 12 days – 1000 mg, then 28 days – 400 mg in the morning and afternoon).
Results. Positive effect of Gliatilin was evidenced by prevalence of daily arterial pressure profile type dipper, sympathicotonia intensity regress, vegetative activity stability.
Conclusions. Research study gives grounds to recommend Gliatilin in complex pharmacotherapy for patients with such diseases. This medication has vegetotropic and neuroprotective properties.

Keywords: chronic brain circulation impairment, choline alfoscerate, vegetotropic and neuroprotective properties.

The analysis of literary sources is conducted on issue of syringomyeia. The article deals with the generalized information on questions of etiopathogenesis, classifications, clinics and diagnostics of this disease. Two clinical supervisions of patients with cervicothoracic form of syringomyelia are presented. The results of neurological symptoms analysis and their neurological imaging are discussed. The results of syringomyelia diagnostics are grounded according to the results of differentiation with the dissipated demyelinating encephalomyelitis and syndrome of Personeydzh–Ternera.

Keywords: syringomyelia, clinics, diagnostics.

The analysis of literary sources is conducted on issue of syringomyeia. The article deals with the generalized information on questions of etiopathogenesis, classifications, clinics and diagnostics of this disease. Two clinical supervisions of patients with cervicothoracic form of syringomyelia are presented. The results of neurological symptoms analysis and their neurological imaging are discussed. The results of syringomyelia diagnostics are grounded according to the results of differentiation with the dissipated demyelinating encephalomyelitis and syndrome of Personeydzh–Ternera.

Keywords: syringomyelia, clinics, diagnostics.

Objective – to compare the results of microsurgical and micro endoscopic technology and treatment of intervertebral discs hernias of the lumbar spine.
Methods and subjects. Results comparison of 31 deletion of the lumbar intervertebral disc hernia using Micro endoscopic technique and 200 similar operations using micro discectomy. There were single herniated L4—L5 or L5—S1 discs. Hernia size was more than 6 mm, representing the maximum dimensions in the sagittal plane 12 mm. Clinical symptoms in all patients included radicular pain, and 181 patients had manifestations of radiculopathy. In all cases MRI and standard radiographs of the lumbar in two projections were performed before the surgery.
Results. The results were assessed according to Macnab scale. In the group where micro discectomy was performed, 144 out of 200 patients had an excellent result, 41 – good, 10 – satisfactory, and 5 had unsatisfactory results. Successful result was 97.5 %. Operation duration varied from 18 minutes to 120 minutes, in average 35 minutes. In the group where Micro endoscopic discectomy was performed, 21 out of 31 patients had an excellent result, 6 – good, 2 – satisfactory, 2 – unsatisfactory results. Successful result was 93.5 %. Operation duration varied from 60 minutes to 120 minutes, in average 90 minutes.
Conclusions. Modern micro endoscopic discectomy is a highly effective method of treating herniated discs of the lumbar spine. Its efficiency is comparable to a micro discectomy. It is indicated in the presence of paramedian, mediolateral herniated discs, stenosis of the lateral recession.

Keywords: herniated lumbar discs, micro endoscopic discectomy, microdiscectomy, the results of treatment.

Objective – to improve outcomes in patients with hypervascular tumors intra-, extracranial and neck localization based on the development of new approaches in the use of modern endovascular techniques to extract such neoplasms from the blood flow.
Methods and subjects. The study is based on the results of examination and treatment of 143 patients with hypervascular tumors intra-, extracranial and neck localization who were treated at the SI «Scientific-Practical Center of Еndovascular neuroradiology of NAMS of Ukraine» in the period 2002–2012. In order to carry out super selected cauterization the catheters of different brands were used. They were inserted coaxially through diagnostic catheter. Endovascular manipulations were carried out under the X-ray control. Micro catheters were used in combination with micro conductor of 0.018 and 0.010 inches to reach necessary artery segment. Liquid substances were used as embolization agents (N-butyl-cyanoacrylate, histo acryle, emboline)at a concentration of 1:2–1:8 in dosage 1–2 ml depending on blood supply type of hypervascular tumors.
Results. Results of endovascular embolization were as follows: 51 (43.2 %) cases had reached a total (100 %) devascularization, in 54 (45.8 %) subtotal (70–99 %), in 18 (12.6 %) partial (< 70 %), 20 (14 %) patients the operation failed for technical reasons. We consider 70 % occlusion, which was achieved in 105 (73.4 %) cases, as effective.
Conclusions. Results justify the advantages of endovascular methods application to set a diagnosis and treat hypervascular tumors. Main advantages of pre operative endovascularization are time shortening of the surgery for tumor extraction and decreasing of the volume of post surgery blood lost. Devascularization of hypervascular tumors increases the possibilities of surgery for such tumor extraction and eliminates risk of complications.

Keywords: hypervascular tumor, intra-, extracranial localization, neck, endovascular embolization, technical aspect.

In the present paper the modern problems of different forms of dementia pharmacotherapy have been outlined. A concept of cholinergic pharmacotherapy as an effective way of influence on cognitive decline has been grounded. A main attention is paid to selective acetylcholinesterase inhibitor – rivastigmin as a treatment strategy instrument for neurodegenerative and vascular forms of dementia. Mechanisms of action, clinical efficacy and safety of this medication, it advantages compared with other medications of this group, have been analyzed in details, and expediency of it use in different forms of cognitive, behavior, and psychic impairments in dementia have been grounded.

Keywords: dementia, pharmacotherapy, rivastigmin.

On a basis of evidenced medicine and clinical practice data predictors of therapy choice on different stages of Parkinson's disease are discussed and considered. Indications for use of direct dopamine agonists (on example of ropinirole) across different therapy regimens are outlined, depending on the stage of the disease, age, presence of complications and prognosis of its development, comorbid conditions, the profile of adverse reactions and financial considerations.

Keywords: Parkinson

On a basis of evidenced medicine and clinical practice data predictors of therapy choice on different stages of Parkinson's disease are discussed and considered. Indications for use of direct dopamine agonists (on example of ropinirole) across different therapy regimens are outlined, depending on the stage of the disease, age, presence of complications and prognosis of its development, comorbid conditions, the profile of adverse reactions and financial considerations.

Keywords: Parkinson

The clinical pathogenetic mechanisms of neurological disorders development due to the alcohol abuse have been investigated. The possibilities of defined features application to improve treatment regimen are outlined. The basic clinical neurological syndromes and their features as well as the main pathogenetic mechanisms of the formation of neurological disorders have been revealed by means of estimation of brain bioelectrogenesis, brain structural changes, free radical lipid oxidation state, antioxidant system, free aminoacids pool dynamics, cell membrane structural changes. The treatment regimens with the use of the prophylactic drugs, namely, Actovegin and сiticoline have been optimized. Besides, the positive dynamics of the basic clinical biochemical parameters under the influence of the treatment has been demonstrated.

Keywords: alcohol dependency syndrome, clinical biochemical parameters, dynamics, Actovegin, citicoline.

The article deals with modern reviews of neurotransmission of brain mediators, pathological physiological changes of GABA transmission under some diseases. The analysis of scientific literature regarding corrective medications application was performed. The application of phenibut for some psychoneurological diseases is justified.

Keywords: neuromediator system, GABA transmission, psychoneurological diseases, treatment, phenibut.

The article deals with modern reviews of neurotransmission of brain mediators, pathological physiological changes of GABA transmission under some diseases. The analysis of scientific literature regarding corrective medications application was performed. The application of phenibut for some psychoneurological diseases is justified.

Keywords: neuromediator system, GABA transmission, psychoneurological diseases, treatment, phenibut.

The article deals with modern reviews of neurotransmission of brain mediators, pathological physiological changes of GABA transmission under some diseases. The analysis of scientific literature regarding corrective medications application was performed. The application of phenibut for some psychoneurological diseases is justified.

Keywords: neuromediator system, GABA transmission, psychoneurological diseases, treatment, phenibut.

Objective – to study the neuroimmunoendocrinology peculiarities of forming and clinical course of experimental autoimmune encephalomyelitis (EAE) in rats during early and late postnatal periods.
Methods and subjects. The modeling of EAE was performed in 62 non-lineal white rats on the background of induction of autoimmune encephalomyelitis by active immunization of allogen spinal cord homogenate with Freund’s Complete Adjuvant (CFA) in the doses of 55–60 mg per 100 g body weight with daily evaluation of neurological status on 6-points scale in two compared groups consisted of virgin and first-delivered female rats. Blood sampling was done on the background of daily evaluation of vaginal data. Indexes of the immune status were determined with the content of sex steroid hormones; corticosterone, prolactine, and also IL-2, TNF-α, TGF-β1 by immunoenzyme method.
Results. It was shown that the modeling of EAE after deliveries was characterized by decreasing of morbidity (57.9 %) and mild clinical course predominantly in 72.7 % of immunized animals while 73.7 % of non-delivered female rats had a severe neurological deficit including 36.8 % of  lethal outcomes. The conclusion was done about the favorable course of demyelinating pathology on the background of breast-feeding that in 43 % cases prevents the formation of demyelinating disturbances.
Conclusions. Physiological pregnancy and delivery have the protective influence on the development of EAE.

Keywords: experimental autoimmune encephalomyelitis, multiple sclerosis, morbidity, pregnancy, the course of demyelinating pathology.

Objective – to study the influence of pregnancy and labor on ethological, emotional parameters and motor activity of the rats under the condition of multiple sclerosis modeling.
Methods and subjects. The study was carried out in 20 female nonlinear white rats that were separated into two equal groups: the first contained rats immunized with encephalitogenic mixture, the second contained rats after labor. Their behavior according to Suok-test, the latent immobility period, the severity of neurological disorders and the inflammation of hind limbs were registered in the initial state within 7, 14, 21 and 28 days after the modeling of multiple sclerosis. Moreover, in second group females were examined within 2 days after the labor.
Results. During the experiment in the first group females the level of anxiety and physical activity were reduced, this indicated emotional disorders associated with the development of the «disease» and their transformation into anxiety-depressive state. At the end of experiment in second group females the activity level was close to the original values against the background of relatively high anxiety rate, which indicated quick restoration of the physical state and stress which was present in emotional sphere in rats after the labor. The increasing anxiety in this group of females with multiple sclerosis perhaps is explained by the implementation of maternal instinct and care about offspring.
Conclusions. The study of motor activity, level of anxiety, emotional state, neurological disorders revealed that the previous pregnancy and labor didn’t aggravate the course of experimental multiple sclerosis in rats.

Keywords: experimental multiple sclerosis, motor activity, level of anxiety, emotional disorders, pregnancy.

Peculiarities of topical diagnostics in neurology are indicated, main clinical syndromes are determined, examples of justification and formulation of the topical diagnosis are given.

Keywords: topical diagnosis, clinical neurological syndromes.

Changes of frequency and breath rhythm are considered at pathological processes in the central nervous system. The general principles and determination of acute respiratory insufficiency, its classification by anatomical and physiological changes in an organism are presented. Characteristic pathological types of the breath, which emergence can point to localization of defeat of this or that department of the central nervous system, and their predictive value are defined.

Keywords: acute respiratory insufficiency, pathological types of breath, diagnostics of pathological processes in the central nervous system.

Multiple sclerosis (MS) – a chronic progressive autoimmune-inflammatory neurodegenerative disease of the nervous system, the etiology of which is unknown at present. Great importance in the development of MS belongs to vitamin D. Based on the analysis of domestic and foreign literature we have summarized information on the role of vitamin D in causing to MS and its impact on the course of the disease. The results of the major randomized clinical studies on this subject were given.

Keywords: multiple sclerosis, etiology, vitamin D.

Objective – to compare the results of microsurgical and micro endoscopic technology and treatment of intervertebral discs hernias of the lumbar spine.
Methods and subjects. Results comparison of 31 deletion of the lumbar intervertebral disc hernia using Micro endoscopic technique and 200 similar operations using micro discectomy. There were single herniated L4—L5 or L5—S1 discs. Hernia size was more than 6 mm, representing the maximum dimensions in the sagittal plane 12 mm. Clinical symptoms in all patients included radicular pain, and 181 patients had manifestations of radiculopathy. In all cases MRI and standard radiographs of the lumbar in two projections were performed before the surgery.
Results. The results were assessed according to Macnab scale. In the group where micro discectomy was performed, 144 out of 200 patients had an excellent result, 41 – good, 10 – satisfactory, and 5 had unsatisfactory results. Successful result was 97.5 %. Operation duration varied from 18 minutes to 120 minutes, in average 35 minutes. In the group where Micro endoscopic discectomy was performed, 21 out of 31 patients had an excellent result, 6 – good, 2 – satisfactory, 2 – unsatisfactory results. Successful result was 93.5 %. Operation duration varied from 60 minutes to 120 minutes, in average 90 minutes.
Conclusions. Modern micro endoscopic discectomy is a highly effective method of treating herniated discs of the lumbar spine. Its efficiency is comparable to a micro discectomy. It is indicated in the presence of paramedian, mediolateral herniated discs, stenosis of the lateral recession.

Keywords: herniated lumbar discs, micro endoscopic discectomy, microdiscectomy, the results of treatment.

Цель — сравнить результаты микроэндоскопической и микрохирургической технологии лечения грыж межпозвоночных дисков поясничного отдела позвоночника.
Материалы и методы. Проведено сравнение результатов 31 операции по удалению грыж поясничных межпозвоночных дисков с использованием микроэндоскопической техники и 200 подобных операций с применением микродискэктомии. У пациентов выявлены одиночные грыжи L4—L5 или L5—S1 дисков. Размер грыж превышал 6 мм, максимальный размер в сагиттальной плоскости — 12 мм. Клиническая симптоматика у всех больных включала радикулярные боли, у 181 больного — проявления радикулопатии. Во всех случаях перед операцией провели МРТ-исследование и стандартную рентгенографию поясничного отдела в двух проекциях.
Результаты. Эффективность лечения оценена в соответствии со шкалой Macnab. В группе применения микродискэктомии у 144 больных из 200 результат был отличный, у 41 — хороший, у 10 — удовлетворительный и у 5 — неудовлетворительный. Доля общего успешного результата составила 97,5 %. Длительность операции — от 18 до 120 мин, в среднем — 35 мин. В группе использования микроэндоскопической дискэктомии, у 21 больного из 31 результат был отличный, у 6 — хороший, у 2 — удовлетворительный, у 2 — неудовлетворительный. Доля общего успешного результата составила 93,5 %. Длительность операции — от 60 до 210 мин, в среднем — 90 мин.
Выводы. Современная микроэндоскопическая дискэктомия — высокоэффективный метод лечения грыж межпозвоночных дисков поясничного отдела позвоночника. Ее эффективность сопоставима с таковой микродискэктомии. Она показана при наличии парамедианных, медиолатеральных грыж межпозвоночных дисков, стенозе латерального рецессуса.

Keywords: грыжи межпозвоночных дисков поясничного отдела, микроэндоскопическая дискэктомия, микродискэктомия, результаты лечения.

Objective – to improve outcomes in patients with hypervascular tumors intra-, extracranial and neck localization based on the development of new approaches in the use of modern endovascular techniques to extract such neoplasms from the blood flow.
Methods and subjects. The study is based on the results of examination and treatment of 143 patients with hypervascular tumors intra-, extracranial and neck localization who were treated at the SI «Scientific-Practical Center of Еndovascular neuroradiology of NAMS of Ukraine» in the period 2002–2012. In order to carry out super selected cauterization the catheters of different brands were used. They were inserted coaxially through diagnostic catheter. Endovascular manipulations were carried out under the X-ray control. Micro catheters were used in combination with micro conductor of 0.018 and 0.010 inches to reach necessary artery segment. Liquid substances were used as embolization agents (N-butyl-cyanoacrylate, histo acryle, emboline)at a concentration of 1:2–1:8 in dosage 1–2 ml depending on blood supply type of hypervascular tumors.
Results. Results of endovascular embolization were as follows: 51 (43.2 %) cases had reached a total (100 %) devascularization, in 54 (45.8 %) subtotal (70–99 %), in 18 (12.6 %) partial (< 70 %), 20 (14 %) patients the operation failed for technical reasons. We consider 70 % occlusion, which was achieved in 105 (73.4 %) cases, as effective.
Conclusions. Results justify the advantages of endovascular methods application to set a diagnosis and treat hypervascular tumors. Main advantages of pre operative endovascularization are time shortening of the surgery for tumor extraction and decreasing of the volume of post surgery blood lost. Devascularization of hypervascular tumors increases the possibilities of surgery for such tumor extraction and eliminates risk of complications.

Keywords: hypervascular tumor, intra-, extracranial localization, neck, endovascular embolization, technical aspect.

In the present paper the modern problems of different forms of dementia pharmacotherapy have been outlined. A concept of cholinergic pharmacotherapy as an effective way of influence on cognitive decline has been grounded. A main attention is paid to selective acetylcholinesterase inhibitor – rivastigmin as a treatment strategy instrument for neurodegenerative and vascular forms of dementia. Mechanisms of action, clinical efficacy and safety of this medication, it advantages compared with other medications of this group, have been analyzed in details, and expediency of it use in different forms of cognitive, behavior, and psychic impairments in dementia have been grounded.

Keywords: dementia, pharmacotherapy, rivastigmin.

The clinical pathogenetic mechanisms of neurological disorders development due to the alcohol abuse have been investigated. The possibilities of defined features application to improve treatment regimen are outlined. The basic clinical neurological syndromes and their features as well as the main pathogenetic mechanisms of the formation of neurological disorders have been revealed by means of estimation of brain bioelectrogenesis, brain structural changes, free radical lipid oxidation state, antioxidant system, free aminoacids pool dynamics, cell membrane structural changes. The treatment regimens with the use of the prophylactic drugs, namely, Actovegin and сiticoline have been optimized. Besides, the positive dynamics of the basic clinical biochemical parameters under the influence of the treatment has been demonstrated.

Keywords: alcohol dependency syndrome, clinical biochemical parameters, dynamics, Actovegin, citicoline.

Освещены современные взгляды на нейротрансмиссию медиаторов в головном мозге, патофизиологические изменения ГАМК-эргической передачи при ряде заболеваний. Проведен анализ научных публикаций относительно использования препаратов, которые имеют корригирующее влияние именно на эти звенья патофизиологических изменений. Доказана целесообразность использования фенибута при некоторых психоневрологических заболеваниях.

Keywords: нейротрансмиттерная система, ГАМК-эргическая передача, психоневрологические заболевания, лечение, фенибут.

Objective – to study the neuroimmunoendocrinology peculiarities of forming and clinical course of experimental autoimmune encephalomyelitis (EAE) in rats during early and late postnatal periods.
Methods and subjects. The modeling of EAE was performed in 62 non-lineal white rats on the background of induction of autoimmune encephalomyelitis by active immunization of allogen spinal cord homogenate with Freund’s Complete Adjuvant (CFA) in the doses of 55–60 mg per 100 g body weight with daily evaluation of neurological status on 6-points scale in two compared groups consisted of virgin and first-delivered female rats. Blood sampling was done on the background of daily evaluation of vaginal data. Indexes of the immune status were determined with the content of sex steroid hormones; corticosterone, prolactine, and also IL-2, TNF-α, TGF-β1 by immunoenzyme method.
Results. It was shown that the modeling of EAE after deliveries was characterized by decreasing of morbidity (57.9 %) and mild clinical course predominantly in 72.7 % of immunized animals while 73.7 % of non-delivered female rats had a severe neurological deficit including 36.8 % of  lethal outcomes. The conclusion was done about the favorable course of demyelinating pathology on the background of breast-feeding that in 43 % cases prevents the formation of demyelinating disturbances.
Conclusions. Physiological pregnancy and delivery have the protective influence on the development of EAE.

Keywords: experimental autoimmune encephalomyelitis, multiple sclerosis, morbidity, pregnancy, the course of demyelinating pathology.

Objective – to study the influence of pregnancy and labor on ethological, emotional parameters and motor activity of the rats under the condition of multiple sclerosis modeling.
Methods and subjects. The study was carried out in 20 female nonlinear white rats that were separated into two equal groups: the first contained rats immunized with encephalitogenic mixture, the second contained rats after labor. Their behavior according to Suok-test, the latent immobility period, the severity of neurological disorders and the inflammation of hind limbs were registered in the initial state within 7, 14, 21 and 28 days after the modeling of multiple sclerosis. Moreover, in second group females were examined within 2 days after the labor.
Results. During the experiment in the first group females the level of anxiety and physical activity were reduced, this indicated emotional disorders associated with the development of the «disease» and their transformation into anxiety-depressive state. At the end of experiment in second group females the activity level was close to the original values against the background of relatively high anxiety rate, which indicated quick restoration of the physical state and stress which was present in emotional sphere in rats after the labor. The increasing anxiety in this group of females with multiple sclerosis perhaps is explained by the implementation of maternal instinct and care about offspring.
Conclusions. The study of motor activity, level of anxiety, emotional state, neurological disorders revealed that the previous pregnancy and labor didn’t aggravate the course of experimental multiple sclerosis in rats.

Keywords: experimental multiple sclerosis, motor activity, level of anxiety, emotional disorders, pregnancy.

The analysis of literary sources is conducted on issue of syringomyeia. The article deals with the generalized information on questions of etiopathogenesis, classifications, clinics and diagnostics of this disease. Two clinical supervisions of patients with cervicothoracic form of syringomyelia are presented. The results of neurological symptoms analysis and their neurological imaging are discussed. The results of syringomyelia diagnostics are grounded according to the results of differentiation with the dissipated demyelinating encephalomyelitis and syndrome of Personeydzh–Ternera.

Keywords: syringomyelia, clinics, diagnostics.

Objective – to study the efficiency of Gliatilin medication on vegetative reactions, cognitive functions in patients of different age groups with chronic brain circulation impairment of different disease genesis.
Methods and subjects. 140 patients aged from 60–80 years were examined. They underwent clinical, neurological and neuropsychological examination, arterial pressure monitoring, EKG, ultrasound imaging, brain MRI. The attention stability, workability changes, audio and speech memory were examined. Patient of the main group (n = 72) received Giatilin as a component of complex hypotensive and symptomatic therapy (first 12 days – 1000 mg, then 28 days – 400 mg in the morning and afternoon).
Results. Positive effect of Gliatilin was evidenced by prevalence of daily arterial pressure profile type dipper, sympathicotonia intensity regress, vegetative activity stability.
Conclusions. Research study gives grounds to recommend Gliatilin in complex pharmacotherapy for patients with such diseases. This medication has vegetotropic and neuroprotective properties.

Keywords: chronic brain circulation impairment, choline alfoscerate, vegetotropic and neuroprotective properties.

Цель — изучить влияние препарата Глиатилин на вегетативные реакции, когнитивно-мнестические функции у пациентов с хроническим нарушением мозгового кровообращения разных возрастных групп и генеза заболевания.
Материалы и методы. Обследовано 140 больных в возрасте от 60 до 80 лет. Всем пациентам выполнили клинико-неврологическое и нейропсихологическое обследование, мониторинг артериального давления, ЭКГ, УЗДГ, ЭЭГ, МРТ головного мозга. Изучали устойчивость внимания, изменение работоспособности, слухо-речевую память. Пациенты основной группы (n = 72) в качестве компонента комплексной гипотензивной и симптоматической терапии получали Глиатилин (первые 12 дней по 1000 мг, затем в течение 28 дней — по 400 мг утром и в полдень).
Результаты. Положительный эффект применения Глиатилина у пациентов основной группы проявлялся преобладанием суточного профиля артериального давления по типу dipper, регрессом симптомов симпатикотонии, стабилизацией вегетативного обеспечения деятельности.
Выводы. Результаты работы позволяют рекомендовать Глиатилин в комплексной фармакотерапии пациентам с данной проблемой как препарат, обладающий вегетотропными и нейропротекторными свойствами.

Keywords: хроническое нарушение мозгового кровообращения, холина альфосцерат, вегетотропные и нейропротекторные свойства.

Objective – to analyze demographic and clinical data and anatomical features (localization and structure) of secular aneurysms located in the anterior cerebral and anterior communicating arteries, which were coiled.
Methods and subjects. 323 patients with 323 aneurysms had 347 endovascular operations. All aneurysms were delimited on disrupted (312 (96.5 %) patients) and unruptured (11 (3.5 %) patients) groups. 233 (72 %) patients with unruptured aneurysms were operated in acute period, 79 (24.5 %) patients were operated in a cold period.
Results. Initial aneurysms manifested with spontaneous intracranial hemorrhage – 312 (96.6 %), 2 (0.6 %) with unruptured aneurysms with mass-effect and 9 (2.8 %) cold aneurysms – as a waif. Quality of life by Rankin scale after the initial operation: 0 grade – 81 (25.1 %), 1 grade – 91 (28.2 %), 2 grade – 82 (25.4 %), 3 grade – 35 (10.7 %), 4 grade – 17 (5.3 %), 5 grade – nobody, 6 grade – 17 (5.3 %) lethal outcome.
Conclusions. Еndovascular operations are the reliable, little traumatic and effective method of aneurysms treatment. This method allows most of patients to return to the normal life style after treatment: only 5.3 % of lethal cases and 5.3 % cases of disability were indicated.

Keywords: secular aneurysm, anterior cerebral artery, anterior communicating artery, endovascular occlusion.

Цель — проанализировать демографические и клинические данные больных и анатомические особенности (локализацию и структуру) мешотчатых аневризм (МА) бассейна передней мозговой/передней соединительной артерии (ПМА/ПСА), которые были прооперированы эндоваскулярно с помощью спиралей в ДУ «Научно-практический центр эндоваскулярной нейрорентгенохирургии НАМН Украины» в течение последних 6 лет.
Материалы и методы. Прооперировано 323 больных с 323 МА ПМА/ПСА. В целом проведено 347 эндоваскулярных операций. МА распределили на две группы: 312 (96,5 %) МА, которые разорвались (МАР), из них 233 (72 %) прооперировано в острый период, 79 (24,5 %) — в холодный, и 11 (3,5 %) МА, которые не разорвались (МАНР).
Результаты. Первичные проявления заболевания у пациентов с МА ПМА/ПСА были такими: спонтанное внутричерепное кровоизлияние как проявление острой МАР — у 312 (96,6 %) больных, МАНР — 2 (0,6 %) имели объемное действие, 9 (2,8 %) были случайной находкой. Оценка общего состояния больных по шкале Ренкина после первичной операции: 0 баллов — у 81 (25,1 %) пациента, 1 балл — у 91 (28,2 %), 2 балла — у 82 (25,4 %), 3 балла — у 35 (10,7 %), 4 балла — у 17 (5,3 %). 5 баллов не выявлено. Умерли (6 баллов) — 17 (5,3) больных.
Выводы. Эндоваскулярные операции являются надежным, малотравматичным и эффективным способом лечения МА ПМА/ПСА, который позволяет большинству больных вернуться к обычному образу жизни после лечения. Уровень летальности составлял 5,3 %, тяжелой инвалидизации больных — 5,3 %.

Keywords: мешотчатая аневризма, передняя мозговая артерия, передняя соединительная артерия, эндоваскулярная окклюзия.

Despite a great deal of publications, in the modern theory of multiple sclerosis, many problems still remain unsolved, without solving of which no further advances in the diagnosis and treatment can be possible. The present work elucidates "blind spots" in pathogenesis of the disease to indicate the most perspective directions of research, the results of which would allow the optimization of existing diagnostic and therapeutic algorithms.

Keywords: multiple sclerosis, microbial triggers, immunodeficiency, immunotherapy.

Peculiarities of topical diagnostics in neurology are indicated, main clinical syndromes are determined, examples of justification and formulation of the topical diagnosis are given.

Keywords: topical diagnosis, clinical neurological syndromes.

Changes of frequency and breath rhythm are considered at pathological processes in the central nervous system. The general principles and determination of acute respiratory insufficiency, its classification by anatomical and physiological changes in an organism are presented. Characteristic pathological types of the breath, which emergence can point to localization of defeat of this or that department of the central nervous system, and their predictive value are defined.

Keywords: acute respiratory insufficiency, pathological types of breath, diagnostics of pathological processes in the central nervous system.

Multiple sclerosis (MS) – a chronic progressive autoimmune-inflammatory neurodegenerative disease of the nervous system, the etiology of which is unknown at present. Great importance in the development of MS belongs to vitamin D. Based on the analysis of domestic and foreign literature we have summarized information on the role of vitamin D in causing to MS and its impact on the course of the disease. The results of the major randomized clinical studies on this subject were given.

Keywords: multiple sclerosis, etiology, vitamin D.

Оbjective – to estimate the brain structures functional state during the ischemic stroke early restorative period by means of auditory cognitive evoked potentials P300 and acoustic brainstem evoked potentials.
Methods and subjects. 78 patients who had hemispheric ischemic stroke and 14 practically healthy subjects were under the examination. Functional brain and brainstem structures state were assessed with method of evoked potentials P300 and acoustic brainstem evoked potentials.
Results. It was found that changes of P300 latency did not depend on the lesion focus in patients with mild stage of dependence according to Bartel scale. Patients with moderate stage of dependence had significant changes of P300 on the ischemia focus location, in some patients there were no changes admitted. Changes of acoustic brainstem evoked potentials in all patients proved the concernment of upper stem level of different evidence.
Conclusions. Combined application of evoked potentials, connected with the action, and acoustic brainstem evoked potentials provides with the possibilities of accurate estimation of brain and brainstem structures state in patients in early restoration post stroke period.

Keywords: ischemic stroke, evoked potentials.

Цель — определить функциональное состояние мозговых структур в ранний восстановительный период ишемического инсульта с помощью метода слуховых  когнитивных вызванных потенциалов Р300 и акустических стволовых вызванных потенциалов (АСВП).
Материалы и методы. Основную группу составили 78 больных, перенесших ишемический инсульт в каротидном сосудистом бассейне, в ранний восстановительный период заболевания, контрольную группу — 14 практически здоровых лиц. Оценивали функциональное состояние головного мозга и стволовых структур с использованием методики вызванных потенциалов P300 и АСВП.
Результаты. У больных с легкой степенью зависимости согласно шкале Бартела увеличение латентности пика Р300 не зависело от стороны очага поражения. У больных с умеренной степенью зависимости по шкале Бартела изменение Р300 было более значимым на стороне очага ишемии, у части больных комплекс Р300 не регистрировался. Изменения АСВП у всех больных отражали заинтересованность преимущественно структур верхнестволового уровня разной степени выраженности.
Выводы. Сочетанное применение методики вызванных потенциалов, связанных с событием, и акустических стволовых вызванных потенциалов позволяет точнее оценить функциональное состояние мозга и стволовых структур у больных в ранний восстановительный период ишемического инсульта.

Keywords: ишемический инсульт, вызванные потенциалы.

Objective – to study the state of cerebral circulation in patients with type 1 diabetes mellitus.
Methods and subjects. 53 patients with type 1 diabetes mellitus (including 23 men, 30 women) were examined. The mean age of patients was 37.8 ± 1.7 years. The control group included 45 people without diabetes mellitus, matched by the age and sex without diabetes mellitus and clinical signs of cerebrovascular pathology. Mean duration of diabetes was 12.0 ± 1.2 years. All patients were on intensified insulin therapy scheme. Investigations were carried out using the extra-and transcranial Doppler ultrasonography for assessing the linear parameters of blood flow and function of the central mechanisms of regulation, using Elegra (Siemens, USA).
Results. As a result of the study the circulation disorders of extra- and intracranial cerebral vessels were revealed, they can cause the development of acute and chronic cerebrovascular disorders in patients.
Conclusions. Decrease in the rate of extracranial blood flow in patients with type 1 diabetes mellitus is significantly lower (p < 0.01) in the common and internal carotid arteries in comparison with a control group. Significantly reduced blood flow velocity in the middle cerebral artery was noticed in patients with type 1 diabetes mellitus comparing to the group of healthy people. The deterioration of the cerebral blood flow may be one of a risk factor for acute and chronic cerebral blood flow disorders in patients with diabetes type 1.

Keywords: type 2 diabetes, stroke, internal carotid artery, middle cerebral artery.

Objective – to study the features of cognitive disorders (CD) in patients with disseminated sclerosis (DS) and to determine their correlation with diffusive cerebral atrophy (DCA) of brain in accordance with MRI data.
Methods and subjects. 60 patients aged from 20 till 65 with DS in the remission stage were under the examination. The first group included 30 patients aged 20–35 years whose DS onset was diagnosed at the age of 24.0 ± 3.1 years; the second group comprised 30 patients at the age of 35–65 years with DS beginning at the age of 43.0 ± 1.5 years. All patients were under the standard neurological examination and had brain MRI.
Results. Neurological examination revealed the presence of DS in patients of both groups. General assessment of cognitive functions by means of MMSE scale was significantly lower in patients of the second group. Under the examination by means of Luria test patients of both group presented disorders in close and long-term reproduction however patients of the second group demonstrated higher rate of disorder. Results of DS and DCA correlation study demonstrated the presence of the correlation in patients of the second group meanwhile it was not noticed in the patients from the first group.
Conclusions. The study revealed that elderly patients have more marked DS according to MMSE scale, Luria test and clock drawing test. It confirms the correlation of brain DCA and DS in elderly patients.

Keywords: disseminated sclerosis, cognitive disorders, diffusive cerebral atrophy.

Цель — изучить особенности когнитивных нарушений (КН) у больных рассеянным склерозом (РС) разных возрастных групп и установить их взаимосвязь с диффузной церебральной атрофией (ДЦА) головного мозга по данным МРТ-исследования.
Материалы и методы. Обследовано 60 пациентов в возрасте от 20 до 65 лет с РС в стадии клинической ремиссии. Первая группа состояла из 30 больных молодого возраста (20—35 лет), дебют заболевания у которых в среднем приходился на (24,0 ± 3,1) года, вторая — из 30 пациентов старшего возраста (35—65 лет) с дебютом РС в (43,0 ± 1,5) года. Всем больным проводили стандартное нейропсихологическое обследование и магнитно-резонансную томографию (МРТ) головного мозга.
Результаты. Нейропсихологическое обследование выявило, что у пациентов обеих групп имеют место КН. Общая оценка когнитивных функций по данным скрининг-исследования с помощью шкалы MMSE оказалась достоверно ниже у больных второй группы. При исследовании мнестической деятельности по тесту А.Р. Лурии у больных обеих групп РС выявлены нарушения в непосредственном и отсроченном воспроизведении, причем у пациентов старшего возраста нарушения были достоверно выше. Результаты изучения взаимосвязи КН и ДЦА свидетельствуют о наличии достоверной связи у больных второй группы, тогда как у больных первой группы она отсутствовала.
Выводы. Проведенное исследование показало, что у больных РС старшего возраста наблюдаются более выраженные КН по результатам оценки по шкале MMSE, теста А.Р. Лурии и теста рисования часов, чем в группе молодого возраста. Установлена связь между ДЦА головного мозга по данным МРТ и КН у больных РС старшего возраста.

Keywords: рассеянный склероз, когнитивные нарушения, диффузная церебральная атрофия.

Несмотря на большое количество публикаций, в теории рассеянного склероза остается много проблем, без решения которых невозможен дальнейший прогресс в диагностике и лечении. Освещены белые пятна в патогенезе этой болезни и указаны направления дальнейших исследований, результаты которых позволили бы оптимизировать существующие диагностические и терапевтические алгоритмы.

Keywords: рассеянный склероз, микробные триггеры, иммунодефицит, иммунотерапия.

Указаны особенности проведения топической диагностики в неврологии, определены основные клинические синдромы, приведены примеры обоснования и формулировки топического диагноза.

Keywords: топический диагноз, клинические неврологические синдромы.

Рассмотрены изменения частоты и ритма дыхания при патологических процессах в центральной нервной системе. Представлены общие принципы и определение острой дыхательной недостаточности, ее классификация по анатомо-физиологическим изменениям в организме. Освещены характерные патологические типы дыхания, появление которых может указывать на локализацию поражения того или иного отдела центральной нервной системы, и их прогностическое значение.

Keywords: острая дыхательная недостаточность, патологические типы дыхания, диагностика патологических процессов в центральной нервной системе.

Рассеянный склероз (РС) — это хроническое прогрессирующее аутоиммунно-воспалительное нейродегенеративное заболевание нервной системы, этиология которого неизвестнa. Большое значение в развитии РС имеет недостаток витамина D. На основе проведенного анализа отечественной и зарубежной литературы обобщены сведения о роли витамина D в возникновении РС и его влиянии на течение данного заболевания. Приведены результаты важнейших рандомизированных клинических исследований, посвященных этому вопросу.

Keywords: рассеянный склероз, этиология, витамин D.

Цель — исследовать состояние церебрального кровообращения у больных сахарным диабетом (СД) 1 типа.
Материалы и методы. Обследовано 53 больных СД 1 типа (23 мужчины, 30 женщин). Средний возраст пациентов составил (37,8 ± 1,7) года. В группу контроля вошли 45 лиц, сопоставимых по возрасту и соотношению полов, без СД и клинических признаков цереброваскулярной патологии. Средняя продолжительность СД составила (12,0 ± 1,2) года. Всем больным назначали интенсифицированную схему инсулинотерапии. Исследования проводили методом экстра- и транскраниальной допплерографии, позволяющим оценить линейные параметры кровотока и состояние центральных механизмов регуляции, с помощью прибора Elegra (Siemens, США).
Результаты и обсуждение. У больных СД 1 типа выявлены изменения кровообращения в экстра- и интракраниальных сосудах головного мозга, что может вызвать развитие острых и хронических нарушений церебрального кровообращения.
Выводы. Снижение скорости экстракраниального кровотока в общей и внутренней сонных артериях у больных СД 1 типа является достоверно более значимым (p < 0,01) по сравнению с контрольной группой. У больных СД 1 типа отмечено достоверное снижение скорости кровотока в средней мозговой артерии по сравнению с группой здоровых лиц. Ухудшение состояния церебрального кровотока может быть одним из факторов риска развития острых и хронических нарушений мозгового кровообращения у больных СД 1 типа.

Keywords: сахарный диабет 1 типа, церебральное кровообращение, внутренние сонные артерии, средняя мозговая артерия.

Цель — оценить эффективность курсового применения мемантина гидрохлорида (Мема) как патогенетически значимого регулятора когнитивных нарушений у пациентов с болезнью Паркинсона (БП) на фоне базисной терапии заболевания.
Материалы и методы. Обследовано 26 больных БП в возрасте 49—74 года со стадией заболевания 1,5–3,0 (по Хену—Яру). Курсовое лечение мемантина гидрохлоридом проведено в течение 3 месяцев с режимом дозирования 5 мг утром и 5 мг вечером.
Результаты. Показаны эффективность и безопасность использования мемантина гидрохлорида (Мема) у пациентов с БП, достоверное уменьшение выраженности когнитивных нарушений, главным образом, нейропсихологических проявлений лобной дисфункции (улучшение способности к обобщению, увеличение ассоциативной беглости), улучшение устойчивости следа памяти к интерференции, внимания и зрительно-пространственных функций.

Keywords: болезнь Паркинсона, когнитивные нарушения, NMDA-рецепторы, мемантин.

Проанализированы литературные источники, посвященные проблеме сирингомиелии. Обобщены данные об этиопатогенезе, классификации, клинических проявлениях и диагностике данного заболевания. Описаны два собственных клинических наблюдения пациентов с шейно-грудной формой сирингомиелии. Представлены результаты изучения неврологической симптоматики и нейровизуализационного обследования. Обоснован диагноз сирингомиелии у данных больных на основании дифференциации с рассеянным демиелинизирующим энцефаломиелитом и синдромом Персонейдж—Тернера.

Keywords: сирингомиелия, клинические проявления, диагностика.

Цель — улучшить результаты лечения больных с обильноваскуляризованными опухолями (ОВО) интра- и экстракраниальной локализации и шеи (ИЭШ) на основании разработки новых подходов с использованием современных эндоваскулярных методик для выключения из кровотока таких новообразований.
Материалы и методы. В основу работы положены результаты обследования и лечения 143 больных с ОВО ИЭШ, находившихся на лечении в ГУ «Научно-практический центр эндоваскулярной нейрорентгенохирургии НАМН Украины» в период 2002—2012 гг. Для суперселективной катетеризации использовали микрокатетеры различных фирм, которые устанавливали коаксиально через диагностический катетер. Эндоваскулярные вмешательства проводили под рентген-контролем. Микрокатетеры применяли в комбинации с микропроводником размером 0,018 и 0,010 дюйма для достижения нужного сегмента артерии. В качестве нерассасывающихся эмболизирующих агентов использовали жидкие вещества (Н-бутил-цианоакрилат, гистоакрил и эмболин) в концентрации 1 : 2—1 : 8 в дозе 1—2 мл в зависимости от типа кровоснабжения ОВО ИЭШ.
Результаты. В результате эндоваскулярной эмболизации в 51 (43,2 %) случае достигнута тотальная (100 %) деваскуляризация опухоли, в 54 (45,8 %) — субтотальная (70—99 %), в 18 (12,6 %) — частичная (< 70 %). У 20 (14 %) больных операция не удалась по техническим причинам. Эффективной мы считаем окклюзию і 70 %, которая была достигнута в 105 (73,4 %) наблюдениях.
Выводы. Результаты исследования свидетельствуют о преимуществах использования эндоваскулярных методов в диагностике и лечении ОВО ИЭШ. Дооперационная эмболизация значительно уменьшает длительность операции по удалению опухоли и объем интраоперационной кровопотери. Деваскуляризация ОВО расширяет возможности радикального хирургического удаления этих опухолей и снижает риск тяжелых осложнений у больных с ОВО ИЭШ.

Keywords: обильноваскуляризованные опухоли, интра-, экстракраниальная локализация, шея, эндоваскулярная эмболизация, технический аспект.

Рассмотрены современные проблемы фармакотерапии различных форм деменций. Обоснована концепция холинергической фармакотерапии как эффективного пути патогенетического воздействия на ослабление когнитивных процессов. Особое место в качестве инструмента лечебной стратегии нейродегенеративных и сосудистых форм деменций отведено селективному ингибитору ацетилхолинэстеразы — ривастигмину. Подробно проанализированы механизмы действия, клиническая эффективность и безопасность данного препарата, его преимущества перед другими препаратами этой группы и обоснована целесообразность его применения при различных формах когнитивных, поведенческих и психических расстройств при деменциях.

Keywords: деменции, фармакотерапия, ривастигмин.

На основании данных доказательной медицины и клинической практики рассматриваются предикторы выбора терапии на разных стадиях болезни Паркинсона. Обосновываются показания для назначения прямых агонистов дофаминовых рецепторов (на примере ропинирола) в разных схемах лечения, в зависимости от стадии заболевания, возраста, наличия и прогноза осложнений, коморбидных состояний, профиля побочных реакций и финансовых соображений.

Keywords: болезнь Паркинсона, лечение, агонисты дофаминовых рецепторов, ропинирол.

Исследованы клинико-патогенетические механизмы развития неврологических нарушений вследствие злоупотребления алкоголем, а также возможность использования выделенных особенностей для оптимизации лечебного процесса. Выделены основные клинические неврологические синдромы, изучены патогенетические механизмы формирования неврологических нарушений путем оценки состояния биоэлектрогенеза головного мозга, структурных изменений головного мозга, состояния свободнорадикального окисления липидов, антиоксидантной системы, динамики пула аминокислот, структурных изменений мембраны клетки. Оптимизированы схемы лечения с применением препаратов полифакторного действия — Актовегина и цитиколина (Цераксона). Показана положительная динамика основных клинико-биохимических показателей под влиянием проведенной терапии.

Keywords: синдром зависимости от алкоголя, клинико-биохимические показатели, динамика, Актовегин, цитиколин.

Цель — изучить нейроиммуноэндокринные особенности формирования и течения экспериментального аутоиммунного энцефаломиелита (ЭАЭ) у крыс в ранний и отдаленный послеродовой период.
Материалы и методы. Моделирование ЭАЭ провели у 62 нелинейных белых крыс на основе индукции аутоиммунного энцефаломиелита посредством активной иммунизации гомогенатом аллогенного спинного мозга с полным адъювантом Фрейнда в дозе 55—60 мг/100 г массы тела. Ежедневно оценивали неврологический статус по 6-балльной шкале в двух группах (девственные и первородившие самки). Забор крови проводили в состоянии диэструса на основании ежедневного исследования влагалищных мазков. Регистрировали показатели иммунного статуса, содержание половых стероидных гормонов, кортикостерона, пролактина, а также ИЛ-2, ФНО-α, ТФР-β1 методом иммуноферментного анализа.
Результаты. Показано, что моделирование ЭАЭ после родов характеризуется снижением заболеваемости (57,9 %) и течением болезни преимущественно в легкой форме (у 72,7 % иммунизированных животных), в то время как у 73,7 % нерожавших самок развивается тяжелый неврологический дефицит при 86,4 % заболеваемости, уровень летальности при этом составлял 36,8 %. Сделано заключение о благоприятном течении демиелинизирующей патологии на фоне грудного вскармливания потомства, которое в 43 % случаев препятствует формированию демиелинизирующих нарушений.
Выводы. Физиологическая беременность и роды оказывают протективное влияние относительно развития ЭАЭ.

Keywords: экспериментальный аутоиммунный энцефаломиелит, рассеянный склероз, заболеваемость, беременность, течение демиелинизирующей патологии.

Цель — исследовать влияние беременности и родов на этологические, эмоциональные показатели и двигательную активность крыс в условиях моделирования рассеянного склероза.
Материалы и методы. Исследования проведены на 20 самках нелинейных белых крыс. Животные, иммунизированные энцефалитогенной смесью, были распределены на две равные экспериментальные группы. Во 2-ю группу вошли самки после родов. Поведение в Суок-тесте, латентный период иммобильности, степень выраженности неврологических расстройств и воспаления задних конечностей регистрировали в исходном состоянии, через 7, 14, 21 и 28 суток после моделирования рассеянного склероза. У самок 2-й группы исследования проводили также через 2 суток после родов.
Результаты. У самок 1-й группы в течение эксперимента снижались уровень тревожности и двигательная активность, что свидетельствует об эмоциональных нарушениях, связанных с развитием болезни, и их трансформации в тревожно-депрессивное состояние. У самок 2-й группы к окончанию эксперимента уровень активности приближался к исходным значениям на фоне сохраняющегося относительно высокого показателя тревожности. Это свидетельствует о более быстром восстановлении физического состояния и сохраняющейся напряженности эмоциональной сферы у крыс после родов, что, возможно, связано с реализацией материнского инстинкта, направленного на сохранение здорового потомства и, соответственно, на продление рода.
Выводы. Исследование двигательной активности, уровня тревожности, эмоционального состояния, неврологических нарушений показало, что предшествующая беременность и роды не усугубляют течение экспериментального рассеянного склероза у крыс.

Keywords: экспериментальный рассеянный склероз, двигательная активность, уровень тревожности, эмоциональные нарушения, беременность.