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Gusev E.I.

Pirogov Russian National Research Medical University (Pirogov University)

Martynov M.Yu.

Pirogov Russian National Research Medical University (Pirogov University);
Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency

Stroke: current state of the problem

Authors:

Gusev E.I., Martynov M.Yu.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(11): 7‑18

DOI: 10.17116/jnevro20241241117

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Table of contents

STROKE: CURRENT STATE OF THE PROBLEM
STROKE: CURRENT STATE OF THE PROBLEM

To cite this article:

Gusev EI, Martynov MYu. Stroke: current state of the problem. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(11):7‑18. (In Russ.)
https://doi.org/10.17116/jnevro20241241117

 
 
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We review the current and emerging topics in ischemic stroke (IS) and intracerebral hemorrhage (ICH). We discuss the association of genetic predisposition and healthy lifestyle, ambient particulate air pollution, weather parameters, variations in the anatomy of cerebral blood vessels, psychological stress, depression, insonmia with the development of IS or ICH. Also, the role of oral anticoagulants (AC) as a new risk factor for ICH is presented. The issues of pathophysiology of IS and ICH are considered, in particular, the discrepancy between blood flow and metabolism and penumbra stability in IS and changes in perfusion and cerebral blood flow (CBF) in stroke, autoimmune mechanisms of brain damage. Widening of therapeutic window, introduction of new generation of thrombolytic medications, tele-thrombolysis and thrombolysis in mobile stroke units are discussed. In patients taking AC, the tactics of prescribing IIa and Xa factor blockers during telethrombolysis and thrombolysis are discussed. The issues of urgent correction of hemostasis in the development of ICH while taking AC, as well as the resumption of their use in the future, are considered. The issues of neuroprotection, including the combination of neuroprotection and telethrombolysis and thrombolysis, and the translation of experimental studies into clinical practice, as well as the implementation of immunomodulatory therapy are discussed.

Keywords:

stroke
penumbra
thrombolysis
reperfusion
recanalization
oral anticoagulants
autoimmunity
DAMPS
neuroprotection
immunomodulation therapy

Authors:

Gusev E.I.

Pirogov Russian National Research Medical University (Pirogov University)

Martynov M.Yu.

Pirogov Russian National Research Medical University (Pirogov University);
Federal Center of Brain Research and Neurotechnologies of the Federal Medical Biological Agency

Received:

10.08.2024

Accepted:

12.08.2024

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