The aim of the present work was to compare the morphological changes occurring at the focus of experimental ischemic stroke treated with agents of the neurotrophic group (alpha-GPC, cerebrolysin), an agent with nootropic properties (piracetam), and a mixed-action agent (vinpocetine). Experiments were performed on 18 rats. Transient cerebral circulatory lesions (acute ischemia) were produced in the right hemisphere by clipping the stem of the innominate artery for 40 min. Light microscopic and electron microscopic studies were performed on fragments of cerebral cortex, brainstem, and cerebellum. Use of alpha-GPC and cerebrolysin increased the tolerance of neurons to ischemic damage and slowed the execution of the cell death program. Intracellular changes were seen and were interpreted as adaptive and reparative: these included folding of the nuclear membrane, abundance of polyribosomes, and endoplasmic reticulum and Golgi complex hypertrophy. These agents preserved the structures of the nuclear membranes and major cellular organelles. When piracetam and vinpocetine were used, all morphological measures indicated inadequate energy provision for repair processes in the acute stage of ischemic stroke. Morphological signs of functional tension of cerebral cortex neurons were seen, with gliocytes in different stages of apoptosis, along with the phenomenon of incomplete separation of gliocytes during proliferation, pathological changes to myelin and non-myelinated fibers, and abnormalities in synapse structure.
Vascular brain diseases resulting from acute ischemia or chronic hypoxia are a serious problem in current healthcare provision. Thus, there has been no decrease in the incidence of ischemic stroke. Gradually progressing chronic cerebral ischemia is also associated with increased disability. The sequelae of acute cerebral ischemia in the form of pareses and paralyses or those of chronic ischemia in the form of intellectual-memory impairments and dementia lead to the imposition of financial and moral costs on the working population. There is a good evidence base for several current approaches to the treatment of stroke patients, used either in the first hours of the development of cerebral catastrophe -thrombolytic therapy -or treatment associated with the prophylaxis of stroke. Another potential direction in the treatment of stroke consists of antioxidant protection of the brain in the most acute period of stroke, which requires grounding in evidence using contemporary methods of paraclinical monitoring, particularly neuroimaging.The use of antioxidants and antihypoxic agents in patients with vascular brain diseases has attracted focused attention over recent decades. The biochemical and pathophysiological grounds for the use of these agents are well known. Hypoxia accompanies many diseases which in turn are risk factors for cerebrovascular pathology. In a number of cases, hypoxia initiates whole cascades of pathophysiological reactions which elicit direct damage to brain tissue. Thus, when the content of peroxide compounds is excesThe aim of the present work was to use MR spectroscopy to assess the quantitative contents and ratios of different metabolites in the infarct nucleus, ischemic penumbra, and unaltered tissue in the opposite hemisphere in patients in the acute period of ischemic stroke. A total of 72 patients were studied, of whom 37 (the study group) received the antioxidant Mexidol (2-ethyl-6-methyl-3-hydroxypyridine succinate) in addition to basal treatment, while 35 patients received only standard treatment without use of antioxidants. Stroke severity was assessed on the NIHSS scale and functional outcomes on day 30 were evaluated using the Bartel index and modified Rankin scale. MR proton spectroscopy was performed twice: during the first 24 h of disease onset and on day 5. Use of the succinate-containing antioxidant Mexidol (500 mg i.v. for 14 days) during the acute period of ischemic stroke significantly decreased the intracellular lactate (p = 0.002) and inositol contents (p = 0.005) from the levels in the control group, which helped restore the balance between the aerobic and anaerobic mechanisms of oxidation and had favorable influences on the rehabilitation potentials of the patients. A positive correlation was found between the lactate content in the ischemic penumbra zone and values on the NIHSS (r = 0.5786, p = 0.049), along with a negative correlation between the lactate content in the ischemic penumbra zone and the level of functional recovery assessed on the Bartel index (r = -0.6305, p ...
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