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The article discusses the principles of neuroprotective therapy as a pathogenetically justified direction in chronic cerebrovascular diseases (CVD). The results of numerous clinical trials demonstrated efficacy, safety, a wide range of pharmacological effects and good tolerability of the powerful antioxidant Idebenone (Neyromet), as well as domestic cytoprotector, Choline alphosceratus of (Cerepro®), affecting the basic pathophysiological processes of the ischemic cascade at CVD. The role of rational multimodal pharmacotherapy of CVD, which provides the necessary energy for the processes of neuroprotection and neuroplasticity of brain cells, is emphasized.