Optimization of treatment for patients with recurrent cerebral hemispheric ischemic stroke in an acute period
Journal Title: Український неврологічний журнал - Year 2018, Vol 0, Issue 1
Abstract
Objective — to optimize treatment in patients with recurrent cerebral hemispheric ischemic stroke (RCHIS) by comparing the effectiveness of mononeuroprotective, combined neuroprotective and neurometabolic as well as basic therapy in the dynamics of an acute period of the disease. Methods and subjects. An open, comparative, cohort, prospective study that included 86 patients aged 50 to 80 years with RCHIS was conducted. All patients were randomized by sex, age, stroke subtype, lesion focus and concomitant pathology. The first observation group included 41 patients who received citicoline in addition to basic therapy, the second group consisted of 26 patients taking combination of citicoline and Actovegin drugs, and the third group consisted of 19 patients who received only basic therapy (antiplatelet, hypotensive drugs, anticoagulants, statin drugs and symptomatic therapy according to indications). On the 1st and on the 13th day of the acute period, all patients underwent a detailed study of the clinicalneurological status with the assessment of the severity of stroke by stroke scale NIH (National Institutes of Health). Cognitive profile was evaluated by scales: MMSE (MiniMental State Examination, MoCA (Montreal Cognitive Assessment) and FAB (Frontal Assessment Battery), On the 21st day of the acute period of RCHIS, the degree of disability was assessed according to the modified Rankin scale (mRS). Results. In the group of patients taking combination therapy with citicoline and Actovegin was observed a statistically significant difference in the mean score on the NIH, MoCA and MMSE scales in comparison with patients taking mononeuroprotective and basic therapy. The average score by mRS in the patients of the second observation group was 2.27 ± 0.15, which associated with favorable functional outcome of the acute period of the disease. Conclusions. Combined action of drugs citicoline and Actovegin contributed to a more active regression of neurological and cognitive deficits and improved clinical and social outcomes of the acute period of the disease and proved superior to mononeuroprotective and basic therapy.
Authors and Affiliations
Novikova L. V.
Keywords
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