Vascular lesions of the brain are the most common cause of mortality and permanent disability in patients. An increase in the frequency of dyscirculatory encephalopathy in the structure of vascular disorders is a social and medical problem that requires the use of modern and safe means to improve prognosis and quality of life of patients. The most promising modern antihypoxant used to protect the brain from ischemia, should be considered Astrox. In the Central Military Clinical Hospital named after P.V. Mandryka (Moscow, Russia) a study conducted to explore the effectiveness of Astrox in patients with discirculatory encephalopathy. The study clearly shown the efficacy and safety of the drug in combination therapy.

The article describes the major aspects of analgesic drug treatment of pain in patients with endstage renal failure receiving chronic hemodialysis. The basic pathophysiological mechanisms of action of drugs on kidney structure. The criteria to be met by a drug administered with the analgesic purpose of nephrology patients. The possibilities of the use of non-steroidal anti-inflammatory drugs, antidepressants and antikonvulantov in the treatment of pain in patients with the studied disease. Presented recommendations for analgesic therapy in patients with kidney disease of foreign nephrologists’ communities.

The article discusses the clinical use of antidepressant sertralin in such neurological syndromes as post-stroke depression, the syndrome of vegetative dystonia, chronic pain. The data are given on efficacy and tolerability. It also discusses issues of dosage and duration of therapy.

Motor system characterized by the complex organization, with the analysis and understanding of integrative mechanisms underlying the implementation of a variety of motor acts continue to be valid until the end of the unsolved problems. The article discusses the most common methods of investigation of the motor system, in particular, how they work, and the advantages of using different diagnostic possibilities.

Cerebrovascular diseases present the leading cause of mortality and permanent disability. A large number of medicinal and surgical methods of treatment and prevention, many of which showed its high efficiency, were created and introduced in clinical practice. The development of new therapies based on the use of mobilizing own resources of organism is promising. The increased tolerance of tissues to ischemia, that is, is considerably interesting. The method is based on the possibility of increasing the tolerance of the medulla to ischemia due to its reversible episodes of ischemia, which have not led to the development of its structural damage. Results of the analysis of modern researches devoted to the study of the protective effects of ischemic preconditioning in patients with coronary and cerebrovascular diseases are shown. The possibility of clinical application of ischemic preconditioning is considered.

Cerebrovascular diseases are the second leading cause of death worldwide. The results of various studies showed a high percentage of young adults among stroke patients. Men have a higher risk of stroke most of their life. Men and women with ischemic stroke differ in risk factors for stroke. The etiology of stroke is also different in men and women. In the course of the work a pro- and retrospective analysis of 90 case histories of young age men with ischemic stroke treated at the vascular department of Yaroslavl city (Russia) in 2013-2015 years was done. Among the patients studied, the average age at the time of ischemic stroke was 38.9 ± 4.9 years. In the sample, there were recorded as primary (n = 63; 70 %) and repeated (n = 27; 30 %) strokes. According to the TOAST criteria with full and in-depth examination of these patients atherothrombotic subtype (46.7 %), lacunar subtype (25.6 %), cardioembolic subtype (4.5 %), ischemic stroke of other known etiology (5.6 %) and unspecified subtype (17.6 %) revealed. As important risk factors among the patients of young age were smoking (especially in combination with hypercholesterolaemia), presence of hypertension, obesity (increased BMI). They make the greatest contribution to the development of atherosclerotic lesions of the carotid arteries in men up to 45 years.

The article deals with classification, diagnostic criteria, clinical features and differential diagnosis of SUNCT-syndrome. Recommendations for management of patients with SUNCT-syndrome in accordance with the modern international concepts of pathogenesis and treatment of this disease are given. We present a clinical example of a typical patient.

Cervicalgia is a widespread pain syndrome, characterized by appearance of pain in the cervical spine and is often accompanied by neurological manifestations (autonomic, sensory, motor disorders). During the year, the back pain experience to 76 % of the population, with severe pain noted in 7 % of cases, and the ability to work because of this localization algii lose about 9 % of the population. Currently, the basic approach to the treatment of cervicalgia is pharmacotherapy. This article describes the main directions of treatment of pain syndrome in the neck. Analyzed non-pharmacological methods of treatment of cervicalgia.

We investigated 49 patients with medically refractory generalized and segmental primary dystonia. All patients underwent bilateral stereotactic electrode implantation for continuous DBS GPi. Mean follow-up ranged from 1 to 8 years. Following constant DBS GPi, all patients experienced gradual alleviation of movement disorders. Mean clinical improvement at the last follow-up was 64.0 ± 17.7% (BFMDRS, motor subscore). According to GOS, excellent and good results were observed in 88 % of patients. In conclusion, DBS GPi appeared to be an effective and a relatively safe treatment for pharmacoresistant primary dystonia. A significantly better outcome was observed in patients with minor disease duration, elder age of dystonia onset, and minor disease severity.

Low stroke symptom public awareness in a case of suspected stroke may lead to a significant decrease of treatment efficacy and rehabilitation potential in that group of patients. Study aim: to increase the efficacy of education of schoolchildren concerning stroke symptoms and correct reactions a short-time period. Population and methods: 522 children attending 1-10 grades filled in a specially designed questionnaire before and after a lecture explaining main stroke symptoms and actions which should be performed in case of suspected stroke, at a relevant age-matched level. Study results: after the lecture an increased understanding of stroke concept (67.7 % compared to 94.4 %; p < 0.05), awareness of stroke symptoms (29.7 % compared to 84.7%; p < 0.05), and the need of emergency call and other actions (17.6 % compared to 80.2 %; p < 0.05) were demonstrated. Conclusions: the study demonstrated that educational programs on stroke symptoms in schools may lead to improvement of stroke outcomes through a correct understanding and adequate reaction of people witnessing it.