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Objective: to study the level of inflammatory biomarkers and growth factors in the peripheral blood of patients with chronic cerebrovascular disease (CCVD) and anamnesis of coronavirus infection COVID-19.Material and methods. The study included patients with CCVD (n=41), 26 of them had a documented anamnesis of coronavirus infection within 4 months before inclusion in the study, 15 people did not have COVID-19. The control group consisted of 20 apparently healthy individuals of the same age. Neuroimaging was performed using a Philips Achieva 1.5 T device. Pro-inflammatory cytokines were determined in blood serum – tumor necrosis factor α (TNF α ), interleukin 6 (IL6), IL18, interferon γ (IFN γ ); chemokines – monocytic chemoattractant protein 1 (MCP-1), IL8; growth factors – vascular endothelial growth factor type A (VEGF-A), transforming growth factor β 1 (TGF β 1).Results. In patients with CCVD, compared with the control group, an increase in the level of proinflammatory cytokines (TNF α , IL6, IL18), chemokines (MCP1 and IL8), a decrease in the concentration of IFN γ , and divergent changes in the content of growth factors (VEGF-A and TGF β 1) were noted. Patients who recovered from COVID-19 showed an increase in the level of IL6 and a decrease in the level of IFN γ compared with those who had not been ill, which indicates a persistently high activity of immunoinflammatory processes and an insufficient humoral immune response.Conclusion. Postponed coronavirus infection COVID-19 aggravates the existing endothelial dysfunction and intravascular inflammation in patients with CCVD, which may probably require changes in their treatment and prevention strategies in the future.

Trimethylamine-N-oxide (TMO) is one of the best studied metabolites of the gut microbiota. It increases the risk of stroke and dyscirculatory encephalopathy, independent of traditional cardiovascular risk factors. The mechanisms of the negative effects of TMO on the cardiovascular system are related to the acceleration of atherosclerosis progression, platelet activation, and the development of aseptic inflammation. Currently, elevated TMO levels are an indication for a strict diet with restriction of foods rich in TMO precursors. Future research should clarify the role of TMO in the development of cerebrovascular disease (CVD). It is necessary to continue the investigation of new compounds that can reduce TMO levels in patients at high risk for developing CVD.

Significant contribution of type 2 diabetes mellitus (T2DM) to the development and progression of cerebrovascular disease (CVD) has been confirmed over the past few decades. The aim of this article is to present the results of many years of research, summarizing generally resolved problems in CVD and T2DM comorbidity, as well as raising several issues that still need to be clarified. Materials and methods. The assessment results of 824 patients with CVD were selected from a large body of data for inclusion in the analysis. Ischaemic stroke was analysed in 250 patients: 128 patients with T2DM (aged 63 [54; 74] years) and 122 patients without T2DM (62 [52; 71] years). The group with chronic CVD consisted of 574 people: 300 patients with T2DM (62 [56; 69] years) and 274 patients without T2DM (63 [57; 68] years). The results of surgery for carotid artery stenosis were evaluated in 170 patients, including 72 patients with T2DM. The control group consisted of 86 persons without CVD (60 [54; 63] years). A wide range of clinical, laboratory and imaging assessments included physical and neurological examinations, neuropsychological tests, blood chemistry, haemorheological and haemostasis tests, as well as neuroimaging studies. Results. T2DM has a significant effect on neurological, neuropsychological, cognitive and functional impairments, as well as on the outcome of acute and chronic CVD, progression of intracranial atherosclerotic lesions, and changes in cerebral and vascular tissue. The impact of the quality of glycaemic control and duration of chronic hyperglycaemia on neurocognitive and structural brain changes has not been completely determined yet. The role of non-glycaemic changes, including influence of several mediators on the vascular and neurodegenerative mechanisms of cerebral tissue damage, warrants further study. Conclusion. The obtained results identify a wide range of unanswered questions and emphasize the need for both possible changes to several clinical algorithms and for ongoing in-depth studies of CVD associated with T2DM.

Cerebrovascular diseases are among the most frequent nosological forms of modern neurology. One of the most important components of their clinical picture is cognitive impairment. At the same time, the most frequent is the development of mild and moderate cognitive disorders. This is especially true for the initial stages of the disease. The pathogenetic basis of the violation of higher cortical functions is a complex of pathophysiological and pathochemical reactions formed within the cascade of ischemic damage to the brain substance. One of the central places among them is occupied by the development of energy deficiency due to a decrease in ATP synthesis and the formation of oxidative stress. This makes it necessary to prescribe pharmacological drugs that can have a multimodal effect. Among such drugs, idebenone is distinguished, which can stimulate the mitochondrial respiratory chain and, in addition, exhibits antioxidant properties. which has demonstrated its effectiveness in the treatment of pre-segment cognitive impairment in patients with cerebrovascular pathology, especially in the framework of combined administration with drugs having other mechanisms of action.

Cerebrovascular disease is one of the most common pathologies in the practice of a neurologist. Vascular cognitive impairment is the earliest and most objective sign of cerebrovascular pathology. The correction of vascular risk factors – antihypertensive, antiplatelet, lipid-lowering therapy, have the leading role in the treatment of patients with cerebrovascular diseases. It is necessary to pay special attention to non-drug methods of therapy, such as quitting smoking and alcohol abuse, regular physical activity. The possibilities of using dipyridamole for symptomatic and pathogenetic therapy are discussed.

The article presents a clinical observation of a comorbid elderly patient with complaints typical for chronic cerebrovascular disease. A careful analysis of the clinical picture and a thorough assessment of the patient’s condition, including testing of cognitive and non-cognitive neuropsychiatric functions, made it possible to identify characteristic syndromes of cerebrovascular disease, which was additionally confirmed by the magnetic resonance imaging. The patient’s therapy regimen was optimized with an emphasis on clinically and pathogenetically justified methods taking into account the main clinical syndromes. Patient’s follow-up assessment has shown that the treatment was accompanied by significant positive dynamic, in both cognitive and emotional signs and symptoms. The article discusses the epidemiology of cerebrovascular diseases, their relationship with other geriatric syndromes in elderly and senile people. The main problems associated with the therapy of cerebrovascular diseases in elderly patients and the ways to eliminate them are discussed.

The most important component of the treatment effectiveness is the adherence of patients to the recommendations of the attending physician, which can affect the course and prognosis of the disease. The problem of adherence in cerebrovascular disease (CVD), depending on the clinical picture of the disease and comorbid diseases, is currently poorly studied.Objective: to assess the degree of adherence to treatment in patients with the main diagnosis of CVD and to determine the factors influencing it.Material and methods. 161 patients with cerebrovascular pathology aged 58–70 years (mean age 64 years) were examined. The assessment of somatic and neurological status, neuropsychological examination, assessment of adherence to therapy using standardized national questionnaires: the Russian Scale of Quantitative Assessment Adherence to Treatment (QAA-25) and the Domestic Therapy Adherence Questionnaire (DTAQ), laboratory studies were performed. The influence of cognitive impairments (CI), background and comorbidities, as well as drug therapy in the framework of the prevention of cardiovascular diseases were evaluated.Results. In patients with CVD, according to the results of the QAA-25 questionnaire, adherence to medical support was 33.4 [26.3; 57.5] %, drug therapy – 44.4 [29.7; 59.0] %, the lifestyle modifications – 31 [26; 55] %, overall adherence to treatment – 31 [26; 56] %. The proportion of patients with low adherence according to the DTAQ test reached 19.9%. In patients with a low adherence, the result on the Montreal Cognitive Assessment Test (MoCA) was 21 points, in patients with very high adherence – 26 points. An increase in the total number of prescribed basic drugs was accompanied by a decrease in adherence according to the results of DTAQ (p=0.041) and QAA-25 (p

A common tool for detecting mild cognitive impairment (MCI) is the Montreal Cognitive Assessment (MoCA). An extension of the standard MoCA testing – MoCA-Memory Index Score (MoCA-MIS; Memory Index, MI) – allows a deeper study of the mechanisms of MCI formation. We consider the drug Prospecta as an effective measure to prevent the progression of MCI.Objective: to study the efficacy and safety of Prospecta in the treatment of MCI in patients with cerebrovascular disease (CVD) in real clinical practice.Material and methods. The observational program PRIORITET included 192 patients of both sexes aged 40 to 74 years inclusive (mean age 63.6±8.8 years) with MCI and CVD, they were prescribed Prospecta, two tablets twice a day during 24 weeks. The presence of MCI was confirmed by testing on the MoCA scale; MI was assessed additionally`. At the end of treatment, the condition of patients was assessed using the Overall Clinical Impression Scale and the safety of the therapy.Results. The change in the mean score on the MoCA scale after 24 weeks of therapy with Prospecta was 5.3 (p26 points), reached 48.9%. Additionally, patients were divided into groups depending on the results of testing on the MoCA scale and MI. During therapy with Prospecta, the number of patients in the MIS

Objective – demonstration of the effective using of modern techniques in the treatment of ischemic stroke by the work of the regional center of cerebrovascular disease in Novokuznetsk. Methods. There is an analysis of the use of intravenous thrombolytic therapy and thromboextraction in patients with verified ischemic stroke. Thrombolytic therapy was carried out with «Actilyse». The dose was calculated of 0.9 mg per 1 kg of patient's weight. Thromboextraction was performed using stent retrievers «Solitaire» or suction system «Penumbra». Results. For the period from 2011 to 2021, there were performed 445 procedures of intravenous thrombolytic therapy at the regional center of cerebrovascular disease N 2. The proportion of patients with TLT procedure ranges from 10.1 % to 12.3 % in different years. The severity of neurological deficit according to the NIHSS scale before the IV TLT procedure averaged 15.6 ± 7.3 points, and at discharge it was 8.1 ± 6.4 points. It was possible to reduce the mortality rate among patients undergoing TLT from 15.5 % to 4.5 % due to more careful selection of patients in recent years. Also in 2019 the procedure of mechanical recanalization (thrombextraction) was performed in 15 patients, 2020 – 17 patients, 2021 – 8 patients. The use of this method made it possible to reduce the severity of neurological deficit from an average of 18.1 ± 6.3 points to 6.5 ± 4.2 points. Conclusions. When used in practical medicine, TLT and TE have shown high efficiency in the treatment of stroke. The growth in the use of these techniques is due to a number of reasons: 1) transportation of the patient to the nearest vascular center for specialized care; 2) the arrival of young specialists who are ready to apply modern methods of treatment to the department; 3) close cooperation with ambulance workers; 4) use of a special telephone connection from the patient's bed; 5) continuity in the work of medical services – laboratory, radiation, endovascular surgery, neurosurgery; 6) raising awareness of the population about the symptoms of stroke.

This review contains up-to-date information on the fundamentals and clinical aspects of white matter disease in chronic progressive cerebrovascular disease with cognitive impairment, the leading risk factors for which are hypertension and cerebral atherosclerosis. Highly informative methods of neuroimaging have contributed significantly to the study of this problem, confirming the important role of white matter changes in the development and progression of cognitive impairment. The full range of the morphological changes in white matter, typical of vascular encephalopathy and cognitive dysfunction, is presented. Chronic hypoperfusion and white matter ischaemia play a leading role in the pathogenesis of white matter changes in vascular dementia development, but alternative hypotheses are also emerging. Further fundamental morphological and clinical studies will help to determine the leading mechanisms of white matter damage in patients with vascular and other age-related forms of dementia. This is necessary for the development of effective methods of treatment and prevention.

Alzheimer’s disease (AD), cerebrovascular disease and their combination are the most common causes of cognitive impairment (CI) and therefore disability in senior citizens. Mutual influences, manifestations and diagnostics of AD and vascular CI are analyzed. The presence of a vascular component in the development of CI indicates the possibility of their prevention. Treatment of CI is based on correction of vascular factors, non-drug and drug methods to improve cognitive functions. Psychosocial and behavioral methods, cognitive training, central acetylcholinesterase inhibitors and memantine are effective in dementia. The use of cerebrolysine in AD and vascular CI is discussed.

The article touches upon micro-RNA as new, potentially significant diagnostic, prognostic and therapeutic biomarkers in cerebrovascular pathology. Synthesis processes and effector mechanisms of micro-RNA are described. The micro-RNA that play an important role in the pathogenesis of major risk factors for cerebrovascular pathology (atherosclerosis, arterial hypertension, atrial fibrillation, diabetes mellitus) and the micro-RNA in acute cerebrovascular disorders are reviewed in detail. The need for thorough replication studies to justify the choice of micro-RNA and methods for micro-RNA detection is substantiated.

Objective: To establish specific features of executive functions (EF) impairment and attention in vascular cognitive impairment (VCI) and Alzheimer's disease (AD)., Material and Methods: Eighty people (over the age of 50) diagnosed with cerebrovascular disease (CVD) and AD, as well as 29 healthy volunteers (control group), were examined. The following neuropsychological methods were used to study the quantitative and qualitative characteristics of cognitive impairments: Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), EXIT-25, Frontal Assessment Battery (FAB), Clock Drawing Test, «12 Words» test, verbal associations (literal and categorical) method, Trail Making Test A and B, Symbol-Digit Modalities Test (SDMT), Stroop Test, and Benton Visual Retention Test. Mandatory inclusion criteria in the study included having a completed magnetic resonance imaging (MRI) of the brain (in T1, T2, FLAIR, DWI, SWI modes) within 1 year before enrollment in one of the groups., Results: No significant differences in age, sex, and level of education were found between the groups. Groups AD and CVD were also comparable in the severity of cognitive impairment overall. Attention and working memory deficits were observed in both CVD and AD, with slightly more pronounced deficits in the AD group. Qualitative analysis of individual components of working memory revealed that both CVD and AD groups had comparable cognitive control impairment compared to the control group, while AD was characterized by a more significant decrease in intellectual flexibility compared to CVD. Sustained attention was equally impaired among patients in the CVD and AD groups, with a significant difference from the control group ( p <0.05). In terms of memory, it was found that auditory-verbal memory and semantic memory were significantly more affected in AD, while visual memory was impaired in both conditions., Conclusion: Attention and EF impairments are not specific to the «subcortical» type of cognitive disorders. Already in the early stages, AD is characterized by a significant impairment of attention and EF, and such a component of EF as intellectual flexibility suffers at the onset of AD to a greater extent than in VCI. Memory impairments are not specific to AD; already at the onset of VCI, visual memory impairment comparable to AD is noted. The obtained data can be used for early neuropsychological diagnosis and differential diagnosis of dementing cerebral diseases.

Objective. To assess main epidemiological indicators for hypertensive crises (HC) in the population of productive age and to study possible correlations of crisis associated arterial hypertension (AH) with clinical and instrumental phenomenon of chronic cerebrovascular diseases. Materials and methods. Data of several studies presented: cross-sectional studies of 726 people aged 35-64 and 415 people aged 40-59. Observational cohort study of 109 patients aged 57.4±5.8 with uncomplicated AH. For the detection of HC in anamnesis, there were used special criteria which widens standard HC definition for additional account of light and mild severity cases. Results. Overall AH prevalence was 45% (95% CI 41-51), in men - 48% (40.2-55.9), in women - 45% (38.4-51.6). History of HC in anamnesis was 11.8% (95% CI 9-15.2), in men 8.8% (5.4-14) and in women - 13.8% (10-18.7). Proportion of HC associated AH defined at the level of 25-30% of all AH cases. The most prevalence of HC associated AH was found in people with “high normal” (130-139/85-89) arterial pressure - 37%. Prevalence of the complaints on headaches, dizziness, poor memory and lower intellectual productivity was higher in people with HC. Chronic cerebrovascular disease was found 2-fold frequently in HC associated AH. But in generally analysis of possible correlations of HC with clinical and instrumental phenomenon of chronic cerebrovascular diseases didn’t revealed any statistically significant differences. Conclusion. HC burden for healthcare system is serious, because it is important risk factor for cerebrovascular diseases and associated with significant lowering of the quality of life. Prevalence of the HC cases with light and mild severity is underestimated. Despite that the study of the most prevalent forms of HC (rare, light and mild severity) didn’t find any associations with morphological or persistent clinical pathology, functional phenomenon were found statistically significant frequently.

Introduction. Despite the development of numerous drugs with neuroprotective activity, their efficacy in cerebrovascular disease remains low, which may partly be due to the efflux function of protein ABCB1 and insufficient penetration of the blood-brain barrier by these drugs. Aim to evaluate the potential to inhibit ABCB1 functional activity in the blood-brain barrier to improve the efficacy of neuroprotective therapy against brain ischemia. Materials and methods. An experimental study was performed on 60 adult male Wistar rats split up into 5 groups: group 1 with falsely operated animals; group 2 with rats with modeled cerebral ischemia using bilateral ligation of the common carotid arteries and preliminary intravenous injection of saline (control ischemia); group 3 with animals that were intravenously administered a neuroprotective agent, an АВСВ1 substrate (nimodipine), 30 min before arterial ligation; group 4 with rats that were intravenously administered an АВСВ1 inhibitor (omeprazole) 30 minutes before disease modeling; and group 5 with animals with ischemia that were intravenously administered nimodipine together with omeprazole before the operation. The efficacy of the tested substances was based on a reduction in animal deaths and the severity of neurological deficits 4, 12, 24, 48, and 72 hours after pathology modeling. Results. The combination of nimodipine and omeprazole increased rat survival after ischemia modeling and decreased neurological deficits compared with the control rats with cerebral ischemia and the rats administered a neuroprotective agent. Conclusion. The combination of a neuroprotective agent (ABCB1 substrate) and a transporter inhibitor provides an effective approach to improve the efficacy of neuroprotective pharmacotherapy in cerebral ischemia.

The paper presents experts' opinion on the clinical manifestations and diagnosis of chronic cerebrovascular disease (CVD) (chronic cerebral ischemia (CCI) and dyscirculatory encephalopathy (DEP)) at the pre-dementia stage. It is noted that DEP/CCI is a common diagnosis in Russian neurological practice, the criteria for which have not been updated for a long time. DEP/CCI most often develops in the presence of cerebral small artery (CSA) disease (cerebral microangiopathy (CMA)), the severity of which can be quantified by magnetic resonance imaging. The main clinical manifestation of DEP/CCI is cognitive impairment that may be subjective or moderate at the pre-dementia stage. Emotional disorders (apathy, depression, anxiety) and instability are considered as possible manifestations of CSA disease. It is noted that headache and vestibular vertigo are not caused by chronic CVD; while in patients with CMA, they are usually associated with other diseases (primary headache, peripheral vestibular vertigo, and vestibular migraine). The diagnosis of DEP/CCI should be based on the presence of cognitive impairment, reliable neuroimaging signs of CVD, and the exclusion of another cause of cognitive impairment.

Objective: to compare standardized mortality ratios (SMRs) from cerebrovascular diseases (CVD) among populations aged 50 years or older in Russia and the USA; to discuss the reasons for the differences.Patients and methods. The investigators calculated SMRs from CVD for men and women aged 50 years or older in Russia (2000–2014) and the USA (1999 to 2013), which corresponded to the 3- and 4-digit codes of the International Statistical Classification of Diseases and Health-Related Problems, 10t h edition (ICD-10). The European standard (European Standard Population, ESP-2013) was used to standardize SMRs.Results and discussion. The SMRs per 100,000 population from all CVD forms for men aged 50 years or older are 1353 in Russia and 185 in the USA; these for women are 1080 and 175, respectively. The CVD SMRs in percentage of SMRs of all circulatory diseases in Russia were 33.5 for men and 39.6 for women and those in the United States are 14.6 and 19.6, respectively. In Russia, the highest death rates due to CVD fall in the category «Other Cerebrovascular Diseases» (I67) are 35.5% for men and 41.3% for women (about 6% for men and women in the USA); those followed by the rubrics «Cerebral Infarction» (I63) (20.1% for men and 19.2% for women (about 6% for both men and women in the USA)); «Stroke, Not Specified as Hemorrhage or Infarction» (I64) (26% for men and women (about 55% for men and women in the USA)). The death rates from non-traumatic intracranial hemorrhage (I61–I62) in the USA are 18.9% for men and 16.3% for women; those in Russia are 9.5 and 8.6%, respectively. As for all 3-digit codes, SMRs are higher in Russia than those in the USA, with the exception of «Other Nontraumatic Intracranial Hemorrhage» (I62).The reasons for the revealed differences are discussed. The differences in CVD mortality rates in the United States and Russia are linked to a number of reasons, most of which are due to the peculiarities of selecting the underlying cause of death and using the ICD-10 codes.

Objective: to evaluate the effect of piribedil on cognitive functions in elderly patients with chronic cerebrovascular disease (CCVD) and cognitive impairment (CI). Patients and methods. A total of 67 patients aged 60-75 years with CCVD and CI were examined. A control group included 32 patients who had received basic therapy with antihypertensive and, if indicated, lipid-lowering and antithrombotic drugs. A study group consisted of 35 patients who additionally took piribedil 50 mg after evening meals for 3 months. Neuropsychological examination was made before and after a treatment cycle. Results and discussion. After 3 months, only the piribedil group showed a significant neuropsychological improvement (p

Chronic cerebrovascular disease (CCVD) is one of the most common iagnoses in Russian neurology, by which is meant vascular cognitive impairment (VCI) in modern foreign literature. There are data available in the literature on the diagnosis and treatment of CCVD (VCI). Theresults of the author’s studies show that CCVD often masks other diseases (anxiety and depressive disorders, primary headache, peripheral vestibulopathy, and Alzheimer's disease) that are unfortunately poorly diagnosed in our country, so patients do not receive effective treatment. To modify risk factors for stroke (smoking and alcohol cessation, sufficient exercise), to normalize blood pressure (the use of antihypertensivemedications), to reduce blood cholesterol levels (statins), to perform antithrombotic therapy (antiplatelet agents and anticoagulants), and to use cognitive enhancers are of key importance when treating patients with CCVD (VCI). There are data on the use of pentoxifylline in patients with CCVD, vascular dementia.

Objective: to investigate the specific features of epilepsy that manifests itself in the presence of chronic cerebrovascular disease.Patients and methods. A total of 304 patients (a study group of 174 patients with new-onset seizures developing in the presence of cerebrovascular disease and a control group of 130 patients with cerebrovascular disease and no seizures) were examined. They underwent clinical neurological examination, electroencephalography (EEG), ultrasonic duplex scanning of extra- and intracranial arteries with functional tests, and visualization of brain structures.Results. Focal seizures were prevalent in the patients with cerebrovascular disease and epilepsy. It was found that there was a preponderance of left-sided localization of EEG foci of abnormal activity and a tendency to more commonly detect subcritical and critical stenoses in the left carotid bed in the patients with epileptic seizures. Diminished perfusion reserves in the posterior circulation system were more frequently observed in the patients with seizures in the presence of cardiovascular diseases. Moreover, the patients with seizures displayed a more profound degree of brain ischemia with the frequent cortical and subcortical localization of dyscirculatory foci. Thus, a study of perfusion reserves, localization of vascular foci, and degree of occlusive changes in the wall of brachiocephalic vessels allows identification of risk factors for epilepsy in the patients with cerebrovascular disease and promotes the prediction of the course of the disease.

Objective: Assessing the dynamics of the long-term trend of prevalence and primary incidence of cerebrovascular diseases (CVD) among different populations of the Kyrgyz Republic (KR). Methods: The main source of information for assessing the incidence of the population of CVD was data from the National Medical Information Center (NMIC) of the Ministry of Healthcare. Retrospective epidemiological study of the prevalence and primary incidence of CVD in the long-term dynamics of 2002-2017 was conducted. Calculated the growth rate (reduction) using the method of the smallest squares to align the dynamic series; a comparative analysis of morbidity rates in groups of age groups and in the context of nine administrative and territorial units of the KR with the calculation of the average multi-year incidence levels (AMIL). Results: In the long-term dynamics (from 2002 to 2017) there is a moderate trend towards an increase in prevalence rates (the rate of growth compared to 2002 was 1.3%) and AMIL 843.9. Among strokes that determine the incidence of CVD, ischemic stroke (60.8%) has the highest proportion. In the long-term dynamics, there is a pronounced tendency to increase unspecified strokes (the growth rate was 10.3%), AMIL incidence – 23.0±2,80/0000. There is a marked upward trend in the incidence of the disease of the studied pathology among children (the rate of increase was 47%). In the 9 administrative territories of the KR there is a fairly strong difference between the AMIL and the CVD among the child population, ranging from 1.00/0000 to 20.90/0000 cases, i.e. territorial differences reach up to 20.9 times; adults and adolescents – from 211.10/0000 to 3127.80/0000 (differences up to 14.8 times). Of the nine administrative territories of the KR, the largest proportion of AMIL morbidity among adults and adolescents is observed in Bishkek, and among children – in the Osh region. AMIL prevalence and primary incidence of strokes in men are statistically, significantly higher than in women. In the long-term dynamics, there is an increase in mortality rates from ischemic strokes with a rate of increase compared to 2002 year – 37.5%, along with a decrease in mortality from hemorrhagic and unspecified strokes. The largest proportion of CVD cases over the past year (2017) is over the age of 70 (32%). Conclusion: The actuality of the problem of CVD in the KR is due to a moderate trend of growth rates of prevalence with the highest proportion of ischemic stroke. The expressed growth trend is caused by unspecified strokes. The largest proportion of AMIL morbidity of adult and adolescent CVD is observed in Bishkek, and among children – in the Osh region. Strokes are more common in males.

Background. The study of the psychological resources of a person experiencing a life-threatening disease is important due to the increased number of social requests related to improving the quality of a patient's full-fledged adaptation to life. The effectiveness of coping with the psychological consequences of a serious illness is determined by the system of internal conditions of the individual as well as by the age characteristics, due to which a subjective assessment of the psychotraumatic situation, the nature of a person's appeal to potential opportunities are specified. Objective. The study focuses on human resources when coping with the psychological consequences of post-traumatic stress, depending on age and the characteristics of the life-threatening brain disease (local or vascular pathology of the brain). Study Participants. 125 people showing no signs of cognitive deficits and who have given their informed consent were involved in the study. Of those, 64 people had a diagnosis of benign meningioma (30–70 years), and 61 people were diagnosed with cerebrovascular disease (31–69 years). Methods. To assess the level of psychotraumatization in respondents, the “Impact of Event Scale” technique was used, emotional and personal characteristics were studied using the Freiburg Personality Inventory and the “World assumptions scale” technique. Results. It has been established that, regardless of the type of disease, caused by local or vascular pathology of the brain, and the age of a person, a common resource for coping with psychotraumatic experiences is, on the one hand, accepting the situation of the disease and on the other, distancing oneself from experiences that mark it as hopeless, causing despair. For people with symptoms of cerebrovascular disease coping with stress, it is more important to regulate relationships with the outside world and maintain their functionality. While for people with meningioma, a positive self-attitude and the focus on unlocking inner potential, which becomes especially relevant in older age, are more important. Conclusions. The resourcefulness of a person in a situation of severe illness is determined by the rational nature of emotional self-regulation, including through selective appeal to social support. Specific resources associated with the peculiarities of the stressful situation of brain disease become more significant with age and manifest themselves in the specifics of the personality orientation (outward or inward).

Dizziness can be caused by different problems in elderly patients; the possibilities of drug therapy are limited; betahistine dihydrochloride is most commonly used.Objective: to investigate the efficiency and safety of combination therapy with mexidol and betahistine in patients with vertigo according to the global assessment scale for treatment efficiency.Patients and methods. The investigation enrolled 89 elderly patients (mean age, 73.7 years) with chronic cerebrovascular disease and complaints of dizziness. Neurological, otoneurological (the orthostatic test, the forced hyperventilation test, the Dix–Hallpike test, the Tinetti test, and the visual vertigo analogue scale), somatic, cognitive and emotional statuses were evaluated in all the patients. The patients were randomized into two groups. A study group included patients who took betahistine 48 mg/day, intravenous Mexidol® 5.0 ml for 10 days, then 375 mg tablets daily for 50 days; a comparison group consisted of patients who used only betahistine 48 mg/day for 60 days. The efficiency of treatment in both groups was evaluated using the global scale on day 60 of therapy, by taking into account the opinion of a physician and a patient.Results. In the elderly patients, vertigo was caused by several problems in the majority (75%) of cases. The combined (betahistine + mexidol) treatment group showed a more significant (more than double) reduction in the symptoms of vertigo than the comparison group.Conclusion. In elderly patients with chronic cerebrovascular disease and vertigo, combined therapy with betahistine and mexidol, which has neuroprotective properties, improves the results of treatment.

Aims. Current study was aimed to identify symptoms and risk factors for depression and anxiety and to estimate quality of life (QoL) in patients with diabetes mellitus type 2 (T2DM) and cerebrovascular disease (CVD). Materials and methods. We examined 73 patients with T2DM. 1st group included 49 patients with T2DM and CVD, 2nd group - 24 patients with T2DM and no cardiovascular pathology. The groups were not significantly different in terms of age, BMI, level of HbAlc, fasting and postprandial glycemia. All patients received antihyperglycemic and antihypertensive therapy. Anxiety and depression were diagnosed with Beck Depression Inventory and Spielberger State and Trait Anxiety Scale (SSTAS). SF-36 questionnaire was used for estimation of QoL. Results. 2nd group showed symptoms of anxiety and depressive disorders in 100% and 75% of cases, respectively. 1st group showed significantly more prominent anxiety and depression symptoms. Risk factors for anxiety and depressive disorders in patients with T2DM and CVD were found to be senior age, obesity and atherogenic dyslipidemia. Conclusion. Cardiovascular comorbidity in T2DM significantly decreases QoL, especially in aspects of physical functioning and vitality. Timely diagnostics of anxiety and depression in patients with T2DM and CVD requires development of screening and rehabilitation programs.

The paper discusses the problems of cerebrovascular disease in patients with systemic lupus erythematosus. It proposes a procedure for managing this category of patients.

Aim. To compare clinical manifestations of cerebrovascular disease (CerVD) with the results of modern instrumental examination methods, using the semi-quantitative approach. Material and methods. In total, 40 CerVD patients with ischemic stroke in anamnesis or discirculatory encephalopathy were examined. All participants underwent duplex scanning (DS) of neck and head vessels, magnetic resonance angiography (MRA) of cerebral vessels and positron emission tomography (PET) of the brain. The observed disturbances were coded as “mild” (+), “moderate” (++), or “severe” (+++). Results. Clinical manifestations of CerVD correlated with PET-diagnosed cerebral perfusion disturbances. In 50 % of the cases, cerebral atherosclerosis in CerVD patients was characterised by combined pathology of carotid and vertebro-basilar arteries (CA, VBA), while isolated VBA pathology was relatively rare (10 %). The first-affected segments were extracranial vessels (35 %) or extracranial and intracranial vessels (27 %). A strong correlation between clinical CerVD symptoms and morphological vascular changes at DS and MRA was observed in 45 %. Conclusion. Among CerVD patients, complex instrumental examination could help in assessment of the disease severity, prognosis and therapy choice.

Introduction. Hemorheological abnormalities in patients with Ph-negative myeloproliferative disorders (MPD) may lead to the development and/or progression ofcerebrovascular pathology. Adequate preventive therapy in such cases lowers the risk of cerebral thrombotic complications. Objective. Evaluation of the effect of dipiridamole and acetylsalicylic acid (ASA) on platelet and erythrocyte aggregation, as well as morphofunctional properties of erythrocytes in patients with cerebrovascular disease (CVD) on the background of MPD. Materials and methods. The study comprised 40 patients with various forms of CVD and Рh-negative MPD: 20 patients received dipyridamole, 20 ASA for prevention of cerebral thrombotic complications. Mean study age was 44.6 years [35; 58.5]. A thorough clinical and neurological examination was performed, as well as neuroimaging studies, coagulation tests, analysis of platelet aggregation and rheological properties of erythrocytes. Results. Within the observation period (median 6.3 months) no acute cerebrovascular events in both groups were observed. Platelet aggregation (induced by ADP or adrenaline) was similar in both groups. Dipyridamole and ASA were also similar in their effect on functional properties of erythrocytes. Conclusion. Our findings suggest that the therapeutic effect of dipyridamole concerning CVD is similar to that of ASA. Dipyridamole can be recommended for use in patients with Рh-negative MPD if other antiplatelet agents are contraindicated.

Aim. To detect the most informative ultrasonic signs of cerebral haemodynamics distress in various degrees of severity asphyxia of newborn for the timely correction of cerebral haemodynamics and normal morphofunctional maturation of brain structures in the early neonatal period and childhood.Materials and methods. 78 newborns were examined, including: 25 newborns who had a satisfactory condition at birth and 53 newborns with a mild, moderate and severe condition at birth due to neonatal asphyxia. Ultrasonic examination of brain and Doppler sonography of cerebral blood flow were carried out for all newborns in the first 7 days of life.Results. Echographic and Doppler sonographic criteria of changes in cerebral haemodynamics of full-term newborn with mild, moderate and severe asphyxia were obtained.Conclusion. Cranial ultrasound demonstrates dopplerographic signs of cerebral hemodynamics formation disorders such as hypoperfusion in neonates who have had chronic intrauterine hypoxia in the early neonatal period, and signs of cerebral hyperperfusion in neonates who suffered from acute asphyxia. In neonates who have suffered from acute asphyxia against a background of chronic intrauterine hypoxia, signs of hypoperfusion persisted for a longer period as compared to neonates with chronic intrauterine hypoxia.

Cerebrovascular diseases are the most important cause of morbidityand mortality from cardiovascular disease among adults.Generalized atherosclerosis is the most frequent basis for vascularlesions of the brain, leading to the development of acute and chronicdisorders of cerebral circulation. Polymorphism of clinical symptomscaused not only by lesions of the brachio-cephalic arteries, butalso by simultaneous involvement in the variable-degree atheroscleroticrocess of other vessels, is often responsible for diagnostic difficulties.In the paper, a number of case reports describing patientswith advanced atherosclerotic lesions of different vascular systemsand marked variability of clinical manifestations are presented.Discussed are questions of rational diagnosis and general approachesto treatment of atherosclerosis, as well as questions of asymptomaticbrachio-cephalic stenosis, silent brain infarcts and risk factorsfor atherosclerosis.

The planning and assessment of therapeutic and preventivemeasures aimed at decreasing the burden of cardiovascular diseases(CVD) are impossible without reliable information concerningbasic epidemiologic characteristics and risk factors(RF) for these disorders. This study aimed at investigating theprevalence of risk factors for CVD among people aged 4059years old. As a part of a general population screening 157 malesand 343 females underwent standardized examination. Dataobtained from the study suggest the following prevalence of RF:positive family history of cardiovascular diseases 17%, hypertension 47%, ischemic heart disease 9%, diabetes 3.4%,atrial fibrillation 1.8%, transient ischemic attacks 1.4%,hypertensive cerebral crisis 5.6%. Behavioural risk factors,such as smoking, alcohol abuse and low physical activity, werealso assessed. Differences in frequency of risk factors detectiondepending on sex, age and education have been furthermoredemonstrated. These data substantiate the necessity of improvingthe effectiveness of preventive measures among people aged4059 years old, and might be used for planning and assessmentof the therapeutic and preventive care.

Oliynik S. M. Cerebrovascular disease in Odessa region: epidemiology and prognosis. Journal of Education, Health and Sport. 2015;5(8):236-242. ISSN 2391-8306. DOI 10.5281/zenodo.28211 http://dx.doi.org/10.5281/zenodo.28211 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%288%29%3A236-242 https://pbn.nauka.gov.pl/works/608388 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014 http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.06.2015. Revised 15.07.2015. Accepted: 12.08.2015. Cerebrovascular disease in Odessa region: epidemiology and prognosis Oliynik S. M. Odessa National Medical University, Odessa, Ukraine Abstract Cerebrovascular disease in Odessa region: epidemiology and prognosis. Oliynik S. M. Odessa National Medical University, Odessa, Ukraine The study was aimed to assess the incidence and prevalence of cerebrovascular diseases in Odessa Region. There was demonstrated that Odessa region has higher rates of CVD incidence and prevalence. The areas of high risk include Bessarabia and Dunabe districts belonging to the southern districts of Odessa region which are characterized with high environmental pollution and unfavorable mineral composition of drinking waters. The preventive strategies which could cut the current rate of CVD incidence are discussed. Key words: cardiovascular disease, stroke, epidemiology, Odessa region.

Aim: organization and follow-up of a registry of patients with cerebrovascular disease in in special department. Materials and methods. In the period from January 2011 to December 2013 all cases of cerebrovascular disease in the special department were recorded. Each patient had an electronic case book and thematic record, developed on the basis of the materials of the National Stoke Association of "Registry of stroke." Results. 418 cases of cerebral stroke were registered. Male to female ratio was 3.7: 1. Patients with initial diagnosed cerebral stroke were 78%, secondary 22%. The average age of patients was 63. The big number of strokes was observed in men aged 56-57 years; in women aged 75-77 years. TOAST criteria for subtypes of ischemic stroke were distributed to: atherothrombotic (29,3%), cardioembolic (29,1 %), 22,4% lacunar ischemic stroke due to other established reasons (8,8%), crptogenic (10,4%). Hemorrhagic stroke was observed in 16.8% of cases. Parenchymal hemorrhage was observed in 10.7% of cases, nontraumatic subarachnoid hemorrhage (4,5%). Among the risk factors in patients with ischemic stroke identified: arterial hypertension (88,9%), coronary heart disease (43%), heart rhythm disorders (28,4%), diabetes (18,6%). The proportion of endovascular interventions performed for 3 years was 31.2%. Mortality rate was 3.74% (10 people) in 2011; 4.65% (14 people) in 2012; 2.48% (7 people) in 2013. Conclusion. Follow up the hospital stroke registry allowed to estimate the structure andcourse of cerebral stroke, found the risk factors to identify the most important factors of death.

The retrospective study evaluated the risk of using non-steroidal antiinflammatory drugs (NSAIDs) for the treatment of back pain in patients with cerebrovascular disease against a background of rheumatoid arthritis. Acute cardio-and cerebrovascular events were reported in 9.7% of subjects treated with NSAIDs. Adverse effects during treatment were associated with diclofenac and nimesulide. Overall risks were low in the group treated with etoricoxib, allowing for all patients to undergo scheduled courses of NSAID therapy, including upon follow-up visits.

We compared the immediate outcomes of hybrid procedure and step-by-step internal carotid artery (CA) stenting and coronary artery bypass grafting (CABG) in high-risk surgical patients with combined lesions of coronary and carotid vasculature. The indications for hybrid surgery were identified. 50 patients with combined lesions of the coronary bed and the carotid vasculature were divided into two groups. The 1st group had 30 patients (60%), who first underwent CA stenting followed by CABG. The 2nd group included 20 patients (40%), who underwent hybrid procedures (simultaneous CA stenting and CABG). Patients with atherosclerosis of aortoiliac and femoropopliteal segments (p 0.05). On average, the patients of the 1st group were in the Intensive Care Unit (ICU) for 2.91.9 days; the patients of the 2nd group stayed in the ICU for 3.96.4 days (р = 0.42). The average postoperative hospital stay for the 1 st group patients amounted to 10.84.5 days, while that for the 2nd group patients was equal to 10.85.8 days (р = 1). The groups were found to have no statistically relevant differences of complication risks, the length of ICU stay, and the total number of days spent in hospital. If patients with combined lesions of the coronary artery and the carotid artery also suffer from critical lower-extremity stenosis, a hybrid procedure allows surgeons to perform CA stenting.

The problem of cerebrovascular lesions takes on even greater significance with the higher prevalence of both acute and chronic forms of cerebrovascular diseases (CVD). Cognitive dysfunctions that have a pronounced negative impact on the quality of life in patients hold a special place among the various neurological symptoms resulting from cerebrovascular lesions. The incidence of vascular dementia increases with age. The paper considers the main issues of the etiology, pathogenesis and classification of vascular cognitive impairments (VCIs). It proposes criteria for the diagnosis of VCIs in the early stages of the disease. Potentially modifiable factors, such as hypertension, coronary heart disease, orthostatic hypotension, diabetes mellitus, hypercholesterolemia, hyperhomocysteinemia, obesity, et al., are indicated to have a special place among the main etiological causes of VCIs. The timely detection of etiological factors and the assessment of their role in the development of cognitive impairments (CI) in CVD form the basis for managing these patients. The issues of treating CI no dementia in patients with CVD are considered. These included the administration of nootropic, vasoactive drugs, as well as agents that exert a modulatory effect on the cholinergic and glutamatergic systems. The use of neuroprotective and neurotrophic drugs is noted to be promising in terms of the multicomponent mechanism of their action.

Cerebrovascular diseases belong to a group of the major causes of cognitive impairments, in the elderly in particular. The paper presents current ideas on the etiology and pathogenesis of vascular cognitive impairments (VCI). The etiological factors of VCI may be divided into genetic, sociodemographic, and common risk factors for vascular and other diseases. The pathogenesis of VCI is multifactorial; cognitive function decrement results from brain damage due to cerebral circulatory disorders. Damage to the deep white matter portions and basal ganglions plays a leading role in the development of cognitive deficit in cerebral circulatory insufficiency, disrupting the connections between the frontal lobes and subcortical structures (a dissociation phenomenon). Regulatory functions are impaired; instability of volitional attention develops; the speed of thinking processes and the performance of professional and everyday skills are suffered, mnestic functions being impaired to a lesser extent. Impairments in other higher cortical functions, such as speech, gnosis, praxis, thinking, generally occur in the later stages of cognitive deficit. The comprehensive approach to examining patients with cognitive dysfunctions, which encompasses physical examination with a mandatory evaluation of neurological symptoms, neuropsychological testing, laboratory studies, instrumental diagnostic methods, and structural and functional neuroimaging techniques, are most justified now. VCI therapy is a challenging task requiring the specific features of different types of cognitive deficit to be analyzed, by providing a rationale for the choice of medications. Therapeutic effectiveness may be enhanced by rational combined multimodal therapy, by keeping in mind a variety of factors for the pathogenesis of VCI.

A review of the literature on intracerebral hemorrhages is given. The purpose of the work is to systematize morphological characters that make it possible to differentiate intracranial hemorrhages of various origins. A number of features of hemorrhagic strokes characteristic of cerebrovascular diseases and other nosologies are presented. The analysis found that the differential diagnosis of hemorrhagic strokes in cerebrovascular diseases should be carried out with systemic, oncological, infectious diseases, vasculitis, thrombohemorrhagic syndrome, traumatic brain injury, as well as other diseases and pathological conditions that are complicated by acute disorders of the cerebral circulation of hemorrhages.

Objective: To estimate the frequency of long-COVID in patients with chronic cerebrovascular disease, to identify the risk factors for the development of this condition and to analyze effectiveness and tolerability of Vinpocetine and Aertal in treatment of this disease., Material and Methods: The study included 97 patients (64.5±5.2 years), among which 42 were diagnosed with long-COVID. The effectiveness of treatment was analyzed with NRS-P, Post-COVID-19 Functional Status (PCFS), Global Rating of Change Scale (GROC)., Results: Predictors of long-COVID was female gender ( p =0.022), severe COVID-19 ( p =0.035), comorbidities: cardiovascular diseases ( p =0.032), endocrinopathies ( p =0.041), affective disorders ( p =0.021). Significant changes in the functional status of patients were recorded after 20 days of treatment (PCFS), in pain after 10 days (NRS-P). The most pronounced clinical effect (PCFS) was obtained after 1 mth of therapy with vinpocetine and 20 days with aceclofenac (NRS-P). After 30 days 25/59.5% of patients noted a «pronounced» improvement in their own well-being (GROC) without the development of significant side effects., Conclusions: 43.3% of patients with chronic cerebrovascular disease and certain predictors develop long-COVID. Aceclofenac and vinpocetine are effective in relieving a number of symptoms of long-COVID, which requires further study.

The review presents the scientific substantiation of the relationship between age-related cerebrovascular changes and dysregulation of cerebral perfusion, blood-brain barrier (BBB) function and neurovascular units. The ischemic cascade in cerebrovascular disease (CVD) is considered, the main links of which are glutamate excitoxicosis, oxidative stress and neuroinflammation. Endothelial dysfunction and increased BBB permeability play an important role in the development of neuroinflammation. The use of multifunctional drugs aimed at various pathological targets of acute and chronic cerebral ischemia for the purpose of neuroprotection has been substantiated. These drugs include the peptide Cortexin (cattle cerebral cortex polypeptides). Experimental data on the study of its molecular partners in the brain are presented. The clinical efficacy of Cortexin as a neuroprotective drug in CVD has been established in many studies.

The paper presents the results of an open-label study of ethylmethylhydroxypyridine succinate (Neurox) used as a component of combination therapy in 32 patients with cerebrovascular diseases (CVD): 10 patients have experienced ischemic stroke and 22 have suffered from dyscirculatory encephalopathy. The patients with CVD have been found to have clinical improvement and better cognitive functions and to tolerate the drug well.

In the International Classification of Diseases 11th revision in the section «Diseases of the nervous system», it is proposed to distinguish «Cerebrovascular disorder with neurocognitive impairment», which corresponds to both discirculatory encephalopathy (DEP) or chronic cerebral ischemia (CCI) accepted in our country, and also vascular cognitive impairments. The terminology, prevalence, risk factors and pathological basis of the disease are discussed, in particular multiple infarctions, strategic infarctions, cerebral small vessel disease, specific microangiopathies, intracerebral hemorrhage and global hypoperfusion. Post-stroke cognitive impairments are discussed in detail. The article presents relevant data on the pathogenesis of the disease, highlights the issues of clinical and neuroimaging diagnostics. Based on the data presented in the article, we can conclude that the diagnosis of DEP, CCI should be based on the presence of cerebrovascular disease with neurocognitive impairment, which implies the verification of vascular cognitive impairments and reliable neuroimaging signs of cerebrovascular pathology while excluding other causes. Early diagnosis and effective treatment of cerebrovascular disease with neurocognitive impairment (DEP, CCI) is becoming increasingly important, since treatment can slow the progression of the disease and lead to a decrease in the incidence of stroke and dementia.

The article discusses the current trends in the spread of carbohydrate disorders, discusses in more detail the problem of type 2 diabetes mellitus and associated cerebrovascular diseases. The spectrum of the therapeutic effect of the drugs neurox and neupilept is considered in relation to this category of patients.

Review of the literature and the authors own experience on thedissection of cervico-cerebral arteries leading to ischemic strokeand transient ischemic attacks are presented. Discussed areissues of etiology, clinical picture, differential diagnosis andtreatment of this from of pathology of cervico-cerebral arteries.Special attention is paid to modern possibilities of non-invasive invivo diagnosis of dissection of cervico-cerebral arteries on the basisof newest methods of computerized neuro- and angioimaging.

The development of cognitive impairment in old age is often caused by overlapping neurodegenerative and cerebrovascular changes which have a mutually aggravating clinical effect. In recent years, the problem of cerebral amyloid angiopathy (CAA), which is one of the variants of such an interaction, has gained importance. Despite the frequent occurrence of this pathology in the elderly, a unified approach to the treatment of these patients has not yet been developed, especially taking into account the frequent combination with other nosological forms. CAA is a disease associated with both Alzheimer's type neurodegeneration and cerebrovascular pathology. The article presents a clinical case illustrating this situation and discusses the diagnostic algorithm in detail. The characteristics of the pathogenesis and clinical manifestations of CAA and the link between neurodegenerative and cerebrovascular pathologies are discussed.

The paper describes the effects of succinic acid derivatives, such as the new drug Neurox, used in different forms of cerebrovascular disease. The use of oxidants is stated to be one of the lines of therapy for acute ischemic stroke in our country. It is noted that a number of recent clinical and biological investigations demonstrate the efficacy of succinic acid derivatives in the complex therapy for cerebral ischemia.

Carotid atherosclerosis is a significant cause of cerebrovascular disease. However, with many candidate markers, precise assessment of its development and progression risks is still limited. This paper reviews state-of-the-art concepts of microRNA as an atherogenesis biomarker throughout various stages including endothelial dysfunction, cholesterol/lipid metabolism, inflammation, oxidative stress, angiogenesis regulation, and proliferation and migration of vascular smooth muscle cells. Based on the available literature, we have described most significant microRNAs for each stage characterized in brief. We have visualized interactions between microRNAs and validated target genes with MIENTURNET and suggest and justify a set of microRNAs for further pilot studies of carotid atherosclerosis.

Introduction. COVID-19-related stroke is associated with a significantly higher mortality than COVID-19 or stroke alone. Mechanisms underlying the increased mortality of patients with stroke and COVID-19 should be thoroughly studied. Objective: to analyze predictors of hospital mortality associated with COVID-19-related stroke. Materials and methods. We retrospectively analyzed 1,386 cases of COVID-19-related stroke reported by an infectious diseases inpatient clinic in 2020. We studied clinical, laboratory, and instrumental parameters in patients with different outcomes. Logistic regression was used to identify independent predictors of mortality. Results. 539 (38.9%) patients died during their hospital stay, with 437 (38.0%) deaths from ischemic stroke and 102 (42.7%) deaths from hemorrhagic stroke (p = 0.0001). Independent predictors of mortality associated with COVID-19-related stroke included age, neurological deficit severity measured by NIHSS, COVID-19 severity, and laboratory parameters including white blood cell count, creatinine, glucose, and D-dimer blood levels. Discussion. The results of logistic regression analysis were able to explain only 41% of the variability in hospital deaths among patients with stroke associated with COVID-19. Conclusion. Hospital mortality in patients with COVID-19-related stroke is associated with severity of inflammatory response, impaired coagulation, age, neurological deficit severity, and somatic comorbidities.