Oxidative stress in the pathogenesis of stroke and its correction


1Pirogov Russian National Research Medical University, Moscow, Russia;
2Federal Center of Brain Research and Neurotechnologies, Moscow, Russia;
3Research Center for Examination of Medical Devices, Moscow, Russia;

4Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia;

5Skriabin and Kovalenko Institute of Experimental Veterinary Medicine, Moscow, Russia;

6Research Institute for Healthcare and Medical Management, Moscow, Russia;

7Konchalovsky City Clinical Hospital, Moscow, Russia

We reviewed the role of oxidative stress (OS) in the pathogenesis of ischemic (IS) and hemorrhagic stroke (HS). OS plays a major role in programmed cell death, increased permeability of the blood-brain barrier, astroglial and microglial activation, and local inflammatory response. We also reviewed the current state of neuro- and cytoprotection studies and their translation in clinical practice. With respect to experimental and clinical data the efficacy of long term administration of multimodal cytoprotective drug with antioxidant effect — ethylmethylhydroxypyridine succinate (Mexidol) is discussed during the acute and early recovery period after stroke. Keywords: stroke, reperfusion, oxidative stress, programmed cell death, apoptosis, ferroptosis, hemoglobin, neuroprotection, ethylmethylhydroxypyridine succinate, Mexidol.

Features of the patient management with traumatic brain injury



1Almazov National Medical Research Center, Ministry of Healthcare, St. Petersburg, Russia

2Polenov Russian Research Neurosurgical Institute — Branch Almazov National Medical Research Center, St. Petersburg, Russia

The aim of our study was to consider features of pathogenesis, diagnosis and therapy of traumatic brain injury (TBI) from the viewpoint of neurologist. The mechanisms of emerging injury of the central nervous system, including neuro-inflammation and oxidative stress in patients with TBI, and correlations between clinical manifestations and severity of TBI are discussed. Special attention is paid to the description of certain TBI consequences, e.g. structural drug-resistant epilepsy and post-traumatic stress disorder. We provide evidence for difficulties and lesser availability of rehabilitation programs to patients with TBI during COVID-19 pandemics. One should mention a need for administration of Mexidol as the antioxidant/antihypoxant drug into complex therapy of TBI in such patients. In the period of COVID-19 pandemics, the role of neurologist in management of TBI patients still increases, especially, at the outpatient treatment stage, and when carrying out therapy and medical rehabilitation programs. Keywords: traumatic brain injury, oxidative stress, structural drug-resistant epilepsy, posttraumatic stress disorder, SARS-CoV-2 infection, Mexidol.

Neuroprotection of cerebral accidents in ambulance phase

Voronezh State Medical University n. a. N. N. Burdenko, Voronezh, Russia

Relevance. Neuroprotection is a required component of intensive therapy of cerebral catastrophes on pre-hospital and hospital phases of care. The purpose of the study. Identification features and the effect of neuroprotection of different cerebral accidents. Materials and methods. For determination the level of knowledge and practical skills of neuroprotection of different cerebral accidents were conduct an anonymous voluntary questioning doctors Voronezh city ambulance station. The effectiveness of the use of neuroprotection of cerebral accidents was study by special protocols in practice on Voronezh ambulance station. The results. More good theoretical training believe 75 % doctors. Using mexidolum in complex intensive therapy on the prehospital neuroprotection of cerebral accidents has expressed a positive clinical effect.

Keywords: cerebral accident, neuroprotection, ambulance.

Oxidative stress and its pharmacological correction mexidol in traumatic brain injury

State budget institution of higher professional education «Omsk State Medical Academy» of Ministry for health care of Russia, Omsk, Russia

Abstract. Examined and treated 114 patients with isolated severe head injury at the age of 18 to 55 years. Group I included 61 patients who survived, in group II — 53 patients who died on the 3–15th day post-traumatic period. Patients I and II groups had complex intensive therapy according to existing protocols. 15 patients (subgroup I1) was prepared in the complex therapy meksidol 1200 mg per day for 7–10 days. Against the background of mexidol decreased intensity of lipid peroxidation, maintained at a sufficient level power antioxidant defense system cells, there was an earlier resolution of post-traumatic encephalopathy and recovery of consciousness. The treatment mexidol noted more favorable during the early post-traumatic period, a reduction of complications (χ2=55,4; p<0,0001) — syndrome of acute lung injury, disseminated intravascular coagulation, acute cardiovascular failure, and pneumonia.

Keywords: traumatic brain injury, oxidative stress, mexidol.

Contemporary aspects of diagnostics and treatment of post-traumatic stress disorder in patients with brain injury

State Pediatric Medical Academy, St. Petersburg

Abstract. Thirty four patients (14 females and 20 males, 18 to 44 years old) with a post-traumatic stress disorder (PTSD) after mild brain injury were under observation. To perform scoring of cognitive functions and severity of anxious state, appropriate specific scales - Mini-Mental State examination – MMSE and Covi anxiety scale were employed. Levels of patients’ recovery motivation for their own disease were assessed with a special questionnaire (Recovery Locus of Control). Cognitive functions were decreased, showing mild to moderate disorders in patients with PTSD after brain injury. The levels of motivation for recovery from own disorder proved to be significantly decreased, and an inverse correlation was found between this parameter, and a degree of anxious condition in these patients. Treatment of the patients with Mexidolum improved cognitive functions, motivation, decreased the degree of anxious condition in PTSD. The results of study argue for a necessity of early detection PTSD after mild brain injury and inclusion of modern antioxidant and antianxiety drugs into combined therapy of the disease.

Keywords: post-traumatic stress disorder, brain injury, cognitive functions, anxious condition, Mexidolum.