The new COVID-19 coronavirus infection caused by SARS-CoV-2 is a global health threat. Neurological disorders detected in patients with coronavirus infection have a wide range of clinical signs: headache, dizziness, altered level of consciousness, acute ischemic stroke, intracerebral hemorrhage, cerebral venous sinus thrombosis. Evidence suggests that patients with more severe systemic symptoms were more likely to experience neurological symptoms. The main risk factors for the development of ischemic stroke in patients with coronavirus infection are considered. It was shown that COVID-19 more often occurred in people with vascular risk factors, among which the mortality rate was higher. Various possible and not mutually exclusive mechanisms which may play a role in the development of ischemic stroke in patients with COVID-19 are described in detail, including hyper-inflammatory state («cytokine storm»), «COVID-19-associated coagulopathy», and disseminated intravascular coagulation syndrome. Stroke risk factors associated with the critical condition in these patients are presented. Stroke, the leading cause of death and disability worldwide, requires immediate treatment and decision-making as well as 24/7 availability for specialized vascular centers. The results of observation of patients with acute cerebral circulation disorder in specialized vascular centers 2 months before and 15 days after quarantine due to COVID-19 are presented. The tactics of managing patients with ischemic stroke under conditions of coronavirus infection is considered.
Cognitive impairments in epilepsy are a current problem in neurology. The basis of the idea on the pathogenesis of higher nervous system dysfunctions is the interaction of a few factors that include the form and duration of the disease, gender differences, and the impact of antiepileptic therapy. The role of interattack epileptiform changes in the development of cognitive deficit in adults and epileptic encephalopathies in children is discussed. Up-to-date neurophysiological and neuroimaging diagnostic methods allow the detection of new features in the courseand progression of higher nervous system dysfunctions in epilepsy.
The article presents the data on the state of endothelial function in the normally and in various diseases and conditions. The basic functions of endothelium in modulation of vascular tone, atrombogenicity and thrombogenicity of the vascular wall, regulation of vascular wall adhesion, regulation of vascular growth are described. The main causes leading to the formation of endothelial dysfunction and the mechanisms underlying it are highlighted. Numerous studies on the evaluation of endothelial function in various diseases are presented. The basic methods of drug and non-drug correction of endothelial dysfunction are presented.
Cardiovascular diseases in Russia are leading in the structure of total mortality. Atherosclerosis is considered a progressive inflammatory systemic disease. The role of endothelium in the development of the atherosclerotic process is described in detail. The main functions of endotheliocytes are normal and in various pathological conditions. The main markers of endothelial dysfunction are presented. Data on the development of the atherosclerotic process in time, risk factors are presented. Local and systemic risk factors for atherosclerosis are highlighted. Own data on the frequency of occurrence of atherosclerotic changes in the main vessels of the head in young people (up to 45 years) based on the results of ultrasonic duplex scanning during professional examinations are presented. The main directions of correction of endothelial dysfunction are described.
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