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PostSubject: major neurological centers   Wed May 02, 2007 8:26 pm

These activities can be carried out only when the nature of stroke, there was no doubt, ie when a patient kompyuterno-tomograf RTC study the brain as well as suspected ischemic stroke-angiograficheskoe research vessels, leading to ischemic brain. The main objectives of a specific treatment ishemicheskogo stroke in ostreyshem period are : restoring blood flow (with the full krovosnabzhayuschey hardening of the arteries) and neyroprotektsiya (protection of neuronal structural damage). These tasks can be fully carried out as long as the patient is taken to the hospital within the first three hours after the first signs of a stroke, during the so-called therapeutic window. To restore blood flow using trombolitiki - urokinazu, streptokinazu and tissue activator plazminogena. Assign these drugs only after kopyuterno-tomografi Inspection Research and angiography confirmed the assumption of clogging and no later than 3 h of the stroke. Dose Tissue activator plazminogena is 0,9 mg / kg body weight, medication introduced intravenously. Haemorrhagic complications occur on average 5% of patients (according to different investigators, the figure ranges from 0.7 to 56%). Neyroprotektornaya therapy designed to protect nerve cells from damage, which leads to various metabolic irregularities occurring in the first minutes and hours of a stroke. Neyroprotektornymi properties are : * postsinapticheskie glutamatnyh receptor antagonists (in a pharmacy not receive clinical testing in the major neurological centers); * Presinapticheskie glutamate inhibitors (lubeluzol); * Antioxidants (emoksipin, alfa-tokoferol, karnozin, meksidol); * Calcium channel blockers (nimodipin); * Drugs with neuroprotective effect : nootropil (piratsetam) (in the early days to 12,0 g intravenously drip), tserebrolizin (in the early days of 10,0-20,0 g intravenous drip), semaks. "Tsitoprotektornoe therapeutic window for the application of many neyroprotektornyh products (for example, glutamatnyh receptor antagonists) fairly narrow : the first 5-6 hours after the first signs of stroke. Nootropy and antioxidants are applied throughout the period of acute stroke, shows the efficiency of memory products (nootropil, piratsetam, semaks, tserebrolizin) and the recovery period to improve cognitive and speech disabilities.

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