The article considers modern concepts of idiopathic intracranial hypertension, its etiology and pathogenesis. Diagnostic criteria are given, as well as an overview of the most promising methods of treatment. A clinical case of masculine HH is presented.

Aim. Estimation of the efficacy and safety dabigatran etexilate in patients with non-valvular atrial fibrillation for prevention cardioembolic stroke undergoing electrical cardioversion. Materials and methods. The study included 174 patients with atrial fibrillation and atrial flutter more than 48 hours, which undergoing electrical cardioversion. The first group included 51 patients started warfarin therapy. The second group included 59 patients, who were assigned dabigatran. The third group included 34 patients, who were assigned rivaroxaban and the fourth group with 30 patients on apixaban. All patients underwent electrical cardioversion after exclusion of intracardiac thrombosis. initial evaluation of the results was carried out on the 7th day after electrical cardioversion, and all follow-up of patients was 12 months. Results. The efficacy endpoint (death from all causes, cardiovascular mortality, stroke and / or systemic embolism) did not occur these outcomes in the all arms. in rivaroxaban myocardial infarction occured on the third day after electrical cardioversion in rivaroxaban group. The rate of bleeding in the warfarin group was 21.5 % (11 persons), in the dabigatran group - 8.5 % (5 people), [OR 0.33; 95 % Ci 0.10-1.04) (p = 0.06)], in rivaroxaban group - 20.5 % (7persons) [OR0.94; 95 % Ci 0.32-2.73) (p = 0,91)], in apixaban group 6.7% (2 people), [OR0.26; 95 % Ci 0.05-1.26) (p = 0.07)]. Major bleeding events occurred in two patients in warfarin group and in one patient in dabigatran group during the year of follow-up. Conclusion. The use of direct oral anticoagulants is no less effective than warfarin for the prevention of cardioembolic strokes during electrical cardioversion in patients with non-valvular atrial fibrillation

Relevance. Pain in the back or dorsalgia is still considered an unsolved problem, as it often reduces the quality of life and is often the cause of the disability of young people. Rehabilitation of such patients is complex, taking into account the causes of the onset of the disease: microtrauma (sedentary lifestyle, incorrect posture, unphysiological postures), overweight, inadequate power loads, genetic predisposition, endocrine and immune disorders. To reduce pain syndrome, reduce myotonic syndrome, physiological muscle training, improve the trophic status of muscles and bone-cartilage structures, normalize microcirculation, which as a result leads to an improvement in the quality of life of patients in addition to drug therapy, exercise therapy, manual therapy, methods of electrostimulation. Materials and methods. The efficacy and safety of electrostimulation of the spine muscles in 62 patients with degenerative-dystrophic spine disease with neurological manifestations with the device MV6.03.00A’ as a method of physical rehabilitation were studied. These patients formed the main group. The study involved 54 women and 8 men, whose average age was 52 (45-62) years and 35 (27-58) years respectively. Before the beginning of treatment, all patients signed informed consent and underwent a comprehensive neurological and laboratory exam -ination, the results of which were taken into account in the choice of therapeutic tactics. All patients of the main group received procedures with the device ‘Electrostimulator MV6.03.00A’ 6-10 times a day. The comparison group included 15 patients, comparable by sex and age, who received other physiotherapeutic electroprocedures in the complex therapy of patients with dorsalgia of spondylogenic nature. The electrostimulator MV6.03.00A’ is a portable physiotherapeutic device produced by MB Barbel Co. in the Republic of Karelia, Petrozavodsk, registered for use in medical practice and at home. Low-frequency impulse currents in the form of an exponential and a large area of electrodes make it possible to achieve physiological effects on tissues, deep penetration of currents without pain sensations. Standard methods of descriptive statistics for non-Gaussian data were used to analyze and evaluate the data obtained: the median calculation, as well as the 25th and 75th percentiles. The conjecture on the normality of the distribution was tested using the Kolmogorov-Smirnov test. The reliabilify of the differences in the quantitative parameters for independent samples was determined using the Mann-Whitney test, and for the dependent ones, using the Wilcoxon test. The minimum level of statistical significance for rejecting the null hypothesis was assumed to be 0.05. A package of applied statistical programs SPSS21.0 was used for data processing. Results. In the main study group, an analgesic effect was observed, as well as an improvement in the quality of life and a decrease in the myotonic syndrome. Presumably, the use of this method of electrostimulation leads to a reduction in the use of non-steroidal anti-inflammatory drugs, especially in the situation of their toxic effects and side effects.

Herbal medicinal drugs differ from non-benzodiazepine tranquillizers by lower rate of adverse events and drug interactions. Officinal herbal preparations are considered as an alternative therapy for a short-term subsyndromal or covert’ (mild) anxiety disorders or used to enhance efficacy of prescription drugs.

The review presents current information on chronic migraine and its treatment with antidepressants. The mechanisms of analgesic action of antidepressants are discussed. Details of the effectiveness of individual representatives of antidepressants of different groups. National recommendations on chronic migraine treatment in different countries (United States of America, Europe, Russia) are considered

Vertebral-basilar insufficiency has great medical-social importance: up to 80 % of all cases identified were ischemic strokes, the nature of its occurrence and of which up to 30 % are negative localization of the lesion in the vertebral-basilar vascular pool. The clinical manifestations of the patient appeal to neurologists (dizzy, headaches), to otorinolaringologa (cochleo-vestibular disorders according to the type of tinnitus and hearing loss), to psychologists and psychotherapists (psycho-emotional disorder, and disorder of sleep), etc.; the etiopathogenesis of the cerebral hemodynamics includes besides endovenous vertebrogenic compression of the vertebral arteries (actually the field of neurology) is joined by the problem of deterioration of the venous outflow, venous sinuses into the internal jugular vein and cranial vault are diploic veins through numerous emissary of skull to soft tissue of the head (which increasingly focused on in their research phlebologists), which consequently gives rise to a variety of medical tactics. For the period may 2016 through December 2016 in the Clinic, the GLMED Residence of Health and Longevity was treated 18 patients with vertebral-basilar insufficiency. All the patients underwent a comprehensive examination, which included: a study of neuro-orihopedic status, Doppler ultrasound of the brachiocephalic arteries, ultrasound of the fixation structures of the cervical spine, neuroimaging techniques (CT, MRi). We used the methodology of revitalisation of the patients on the basis of proprioceptive neuro-muscular re-education (PNF) and comprehensive pharmacotherapy with Ginkgo biloba extract EGB 761 (memoplant), horse chestnut extract venoplant (iimproves venous outflow), neuroplant. The methodology of revitalisation of the patients with vertebral-basilar insufficiency showed a high and persistent therapeutic effect, which was expressed in 10 patients in the transition from a progressive type of the disease to regredientes, in 4 patients from a progressive-regredientes to regredientes, while 4 patients remained progressive-regredientes type of the disease unchanged.

52 patients with insomnia who received Reladorm were examined. Cardiointervalometry was performed, subjective characteristics of sleep were tested. In patients with insomnia the prevalence of sympathetic vegetative influences was revealed according to the spectral and statistical indices of cardiointervalometry. In the course of the treatment a decrease in vegetative sympathetic tension was recorded. The total positive effect was determined on the basis of the results of the analysis of the indicators of the scoring of the subjective characteristics of sleep.

Correction of mild cognitive disorders (MCD) in elderly patients is of great medical and social importance. For this important task was used preparation Doppelherz aktiv® Ginkgo Biloba + B₁ + B₂ + В₆ and the method of proprioceptive neuro-muscular re-education (proprioceptive neuro-muscular facilitation, PNF) in 48 patients of the clinics of the medical holding St. Andrew's hospital NEBOLIT (Krasnogorsk), the Residence of Health and Longevity GLMed (Moscow), First University Clinic (Moscow). A pronounced dose-dependent regulating effect on the vascular system of the brain, the release, re-absorption and catabolism of neurotransmitters under the influence of the preparation Doppelherz aktiv® Ginkgo Biloba + B₁ + B₂ + B₆ enhanced and potentiated the effect of improving cerebral hemodynamics diagonal exercises according to the method of PNF and oculomotor gymnastics according to the method of Feldenkrais. Assessment of patients was carried out by methods of neuroimaging (MRI, CT), physical methods of investigation of neurological status, as well as testing on the Montreal scale assessment of cognitive disorders, Hospital depression scale and Life quality scale. Generalization of results of researches for the period from november 2014 to may 2017 showed improvements in most indicators, as a result of the effective combination of modern methods of neurorehabilitation and the preparation Doppelherz aktiv® Ginkgo Biloba + B₁ + B₂ + B₆. Neuroimaging techniques (MRI, CT), analysis of patient complaints in combination with test results allowed to build a chain of diagnostic and treatment events from signs of MCD and detect the organic component in the development of the disease to the creation and successful application of individually-deterministic programs recovery of cognitive and motor functions, through a combination of pharmacological effect of the preparation Doppelherz aktiv® Ginkgo Biloba + B₁ + B₂ + B₆ and the modern methods of neurorehabilitation (method of PNF). The integrated and combined application of modern methods of neurorehabilitation and using of the preparation Doppelherz aktiv® Ginkgo Biloba + B₁ + B₂ + B₆ allows to slow down the progression of the disease and restore cognitive and motor functions, and generally improve the quality of life of elderly patients.

Objective: to study the therapeutic efficacy of L-lysine aescinat angioprotector in the treatment of patients with chronic pain with spinal canal stenosis of the lumbar region. Design: simple open comparative randomized study. Materials and methods. Comprehensive study vertebro-neurological, pain status before and after treatment carried out in 63 patients with stenosis of the lumbar canal syndrome and claudication. As treatment in the main group along with basic therapy used L-lysine aescinat. Results. Before treatment, patients diagnosed chronic pain in the lower back radiating to the lower limbs, motor and sensory disorders, worse when walking. After treatment in the group using L-lysine aescinat angioprotector following significant results were obtained, along with basic therapy: reducing the intensity of pain with exertion, the severity of neuropathic pain component and extension of distance. Conclusions. Appointment of the drug L-lysine aescinat in the treatment of the claudication syndrome in patients with stenosis of the spinal canal is pathogenetically substantiated.

Ischemic stroke (AI) is a common disabling disease, the effectiveness of prevention of which largely depends on the correctly chosen pathogenetic therapy. Acetylsalicylic acid (ASA) has been used for the prevention of AI for many years, but the results of its use are often limited by its low sensitivity. Modern data on the effectiveness of dipyridamole (Curantyl) as a means of secondary prevention of AI, in particular, in conditions combined with ASA therapy, are considered. It is noted that there is reason to expect the most significant result when it is used in patients with atherothrombotic and lacunar AI. Possible complications of treatment are analyzed.