Adipokine apelin through the apelin receptors activates a wide range of signaling cascades in the target cells and controls their growth, differentiation, apoptosis, and energy metabolism. In the recent years, the evidence has been obtained that all components of the hypothalamic-pituitary-gonad axis, in which apelin and its receptor are expressed, are targets of apelin. In the hypothalamus, apelin modulates the activity of the melanocortin and ghrelin systems and indirectly affects the production of gonadoliberin. In the ovaries, it controls the growth and maturation of the follicles, stimulates the angiogenesis, and affects the basal and stimulated by the other factors steroidogenic activity in follicular cells. The changes in the apelin signaling system are closely associated with dysfunctions of the female reproductive system, such as polycystic ovary syndrome, endometriosis, and cancer. Information on the regulation of the male reproductive system by apelin is limited to animal studies showing the effect of apelin on the hypothalamic components of the gonad axis. The participation of apelin in the regulation of the reproductive system opens up the broad opportunities for the development of new approaches for the correction of abnormalities in this system and for the treatment of infertility.

It can be assumed that the reason of failure of classical methods to combat obesity lies in the complete disregard of active involvement of the immune system in the processes of digestion, considering influence of food antigenic load, that  is carried by the human body. The new technology Immunodietology™, based on a mathematically correct calculation of the individual response of the body’s immune system to food antigens, is a promising trend for modern dietetics in addressing issues of prevention and control of obesity.

Aim. To study the features of hypersensitivity to food antigens, as the main trigger of chronic inflammation in the development of obesity and metabolic disorders, to substantiate the personified principles of immunodietology application.

Methods. The study of food hypersensitivity was carried out according to the methodology of Immunohealth™. Enzymelinked immunosorbent assay (ELISA) was used for specific IgG to 111 food antigens, distributed over antigenic clusters, to create an individual adaptation diet, based on the mathematically-based criterion “norm – anomaly”. We determined IL-4, IL-6, IL-10, IL-17, TSH, free T3, insulin in serum by means of ELISA.

Results. A correlation was established between casein hypersensitivity and an increase in IL-6 concentrations (Rs = 0.30 (p < 0.05)); IL-17 (Rs = 0.32 (p < 0.05)), as well as food hypersensitivity (Type III) to casein and the development of atherogenic changes (OR = 2.7 (1.2; 6.3)).

Conclusions. Thus, the results showed that the principles of diagnosis and evaluation, personalized food hypersensitivity are the basis of the new Immunodietology™ technology, which may be a promising trend in modern dietetics to control obesity.

Non-alcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) are serious health problems. Features of liver steatosis (LS) due to NAFLD and ALD in rural areas, including lipid metabolism indicators, depending on body mass index (BMI), have not been thoroughly studied.

Aim. To study the features of lipid metabolism in residents of rural area in LS due to NAFLD and ALD depending on the BMI.

Materials and Methods: 1152 residents of a rural therapeutic site were surveyed. Lipidograms and BMI were analyzed in patients with LS at NAFLD and ALD.

Results. There were no patients with a reduced BMI in the rural medical site. Persons with BMI ≥ 25 among patients with LS on the background of NAFLD (98.2 %) are significantly more frequent than on the background of ALD (55.1 %) (p < 0.001). Among subjects with normal BMI there were more patients with ALD (44.9 %) than with NAFLD (1.8 %) (p < 0.001). There were no significant differences in age in patients with in NAFLD depending on BMI (p > 0.05). Patients with LS of ALD with an increased BMI were older than those with a normal index (p < 0.05). Also, there were no differences in lipidograms with LS on the background of NAFLD and ALD depending on BMI (p > 0.05). Triglyceride levels (TG) and atherogenic coefficient (AC) were significantly higher (p < 0.05 in both cases) in LS with ALD than in patients with NAFLD.

Findings. Disorders of lipid metabolism were found in patients with LS with both increased BMI and normal. At the rural therapeutic site, patients with LS due to ALD have more pronounced lipid metabolism disorders than those ones with NAFLD, regardless of BMI.

Congenital spastic cerebral palsy (СР) is a large group of non-progressive disorders of the nervous system. The basis of the pathogenesis of these conditions is considered the impact of many factors. The clinical diversity of the disease and the syndromic principle of classification determine the existing uncertainties in the diagnosis of these diseases. The multifactorial nature of the underlying brain lesions is obvious and beyond doubt. The volume of information accumulated to date does not allow one to exclude the role and significance of the direct effect of acute asphyxiation in childbirth on a fetus normally formed during pregnancy, the role of infectious brain lesions, and disorders of neuronal migration. It is impossible to ignore the dependence of the clinical picture of the disease on what stage of ontogenesis the impact of the damaging agent occurs. As one of the pathogenetic factors, the genetic determinism of the phenotype of the clinical picture of a disease is fairly considered. This review focuses on the genetic aspects of the pathogenesis of this pathology. The information on monogenic mechanisms of inheritance is analyzed in detail. Such genetically determined mechanisms of pathogenesis as the inheritance of prerequisites for brain trauma in the perinatal period are considered separately. The new clinically significant variants of chromosomal mutations found in patients with CР are reviewed in detail,  the evidence of the influence of genetic factors on the development of cerebral palsy in the absence of a pronounced monogenic cause of the disease, obtained through twin studies, is reviewed.  Lit search of polymorphisms markers of predisposition to the development of cerebral palsy genes of the folate cycle, genes of glutamate receptors, the gene of apolipoprotein and of the gene for the transcription factor of oligodendrocytes (OLIG2) in Detail the role of epigenetic effects on the activity of genes coding for mitochondrial proteins.

Background. To date, there are many pharmacogenetic algorithms for selecting the dose of warfarin. However, there is very little information about the predictive accuracy of the algorithms. We decided to evaluate the predictive accuracy of the Gage algorithm, using a calculator, located on the web site (http://www.warfarindosing.org) in two ethnic groups (Caucasians and Asians), living in Russia.

Aim. To compare the actual warfarin dose (AWD) to the calculated warfarin dose (CWD), using the algorithm in two ethnic groups taking warfarin.

Materials and methods. We included 114 patients (66 Caucasians and 48 Asians): the mean age was

60.91 ± 12.34 years; 61 (53.51 %) men, and 53 (46.49 %) women. The comparative characteristics of the algorithm were tested using the mean absolute error (MAE) between AWD and CWD, and percentage of patients, whose CWD fell within 20 % of AWD (percentage within 20 %). Genotyping for CYP2C9*2, CYP2C9*3, CYP4F*2 and VKORC1 was performed by real-time polymerase chain reaction (RT-PCR) method using Pharmacogenetics Warfarin reagent kits (DNA technology, Russia).

Results. The Gage algorithm produced the predictive accuracy with MAE = 1.02 ± 0.16 mg/day and percentage within 20 % for Asian patients was 39.6 %. We obtained MAE = 1.33 ± 0.16 mg/day and percentage within 20 % for Caucasian patients was 40.9 %. In two ethnic groups (Caucasians and Asians) of the Russian population, overall performance of warfarin pharmacogenetic dosing by the Gage algorithm was similar.

Conclusions. Despite the performance limitation of the current warfarin pharmacogenetic dosing Gage algorithm, constant international normalized ratio monitoring is important.

Background. Intrauterine fetal infection (IUI), the common cause of which is the cytomegalovirus (CMV), occupies one of the first places in the structure of perinatal morbidity and mortality. There are no data on the relative risk assessment of IUI at the exacerbation of CMV infection and its delitescent course in first trimester of pregnancy in the literature.

Aim: to calculate the relative risks of fetal IUI in pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.

Methods. A retrospective review of the labor and delivery medical records and prenatal records of 104 CMV-seropositive women was carried out. Fifty of these women had an exacerbation of CMV infection in the first trimester of pregnancy – main group and 54 of them were with delitescent course of the disease (comparison group).

Results. A comparative analysis of ultrasound and morphological markers of IUI with risk assessment depending on the course of CMV infection in the first trimester of pregnancy has been carried out. A high risk of placental structure abnormalities, as well as amniotic fluid and fetal membranes, fetal and placental blood flow pathology, onset of  choroid plexus cyst and fetal growth restriction was found, with a statistically significant difference in the group of pregnant women with exacerbation of CMV infection in the first trimester of pregnancy.

Conclusion. The findings suggest that the exacerbation of CMV infection in early pregnancy is a risk factor for IUI.

Background. Ischemic heart disease is the leading cause of death in the majority of developed countries, including Russia. It determines the importance of elaboration of individual risk prediction of ischemic heart disease for primary prevention.

Aim: to develop a strategy for predicting the ischemic heart disease in coal industry workers.

Materials and methods. Ischemic heart disease incidence and its risk factors were studied in 196 coalmine workers (sinkers, stope miners). Rose Questionnaire, daily ECG monitoring and bicycle ergometry were used to detect angina. The indices of lipid metabolism, hemostatic system, the level of homocysteine, uric acid, C-reactive protein, constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems were studied.

When elaborating the prognostic system, we used the Bayes method. A prognostic coefficient was calculated for each factor. Prediction of ischemic heart disease was carried out according to the sum of prognostic coefficients.

Results. Ischemic heart disease was detected in 18 (9.2 %) miners. According to the above mentioned indices, a medical technology was elaborated to predict the ischemic heart disease, based on the determination of the most significant risk markers: age, work experience in harmful working conditions, type A behavior, arterial hypertension, fasting hyperglycemia, metabolic syndrome, hypercholesterolemia, decrease in the level of high density lipoprotein cholesterol, increase in the value of low density lipoprotein cholesterol, hypertriglyceridemia, hyperhomocysteinemia, hyperfibrinogenemia, increase in the level of soluble fibrin monomer complexes and C-reactive protein, abdominal obesity, hypersthenic constitutional-morphological type by Rees – Eysenck, genetic markers of blood groups of AB0, P and MN systems.

Conclusion. Based on the most significant markers, a personalized strategy for ischemic heart disease prediction in miners was elaborated, which allowed timely undertaking therapeutic and preventive measures.

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.

Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.

Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.

Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.

Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

The use of magnesium preparations in medicine has a long history. According to some sources, first attempts by humans to consume magnesium- and calcium-rich minerals orally, presumably for medicinal purposes, could have occurred even in prehistoric times. First attempts to use natural magnesium-calcium alkaline materials to increase the bioavailability of the alkaloids of some psychoactive plants, such as betel, tobacco, and coca, also date back to prehistoric times.Later, several ancient authors, in particular, Hippocrates II, Claudius Galen and Soran of Ephesus, have described the profound laxative effect of sea salt and of crushed dolomite, as well as a positive effect on the psyche of drinking mineral waters from sources that were found by modern scientists to be rich in magnesium, lithium and bromine. The laxative effect of mineral waters from some sources rich in magnesium, or of salts that were extracted from such sources was known in the Middle Ages. Later, Paracelsus discovered that these salts could be useful not only as a laxative, but also as a sedative.In 1707, Massimiliano Valentini first obtained magnesium oxide, which immediately found its use in medicine, as an antacid, as a mild laxative and skin powder. In 1926, Jacques Leroy was the first to prove the vital importance of magnesium for the physiology of animals.In this article, we thoroughly review the history of the medicinal use of magnesium preparations and the history of studies of biological role of magnesium, from antiquity to modern times.

Esophageal  bleeding is  one of  the most  common medical emergencies. It takes  the  3rd place among  all digestive hemorrhages, and accounts for 14–16 % among all gastrointestinal bleeding. The most common cause of esophageal hemorrhages is Mallory – Weiss esophageal tear (10–12 %), less often – varicose veins of the esophagus in portal hypertension syndrome (up to 4 %) and, in some cases, is esophagitis of various etiologies (up to 1.6 %). The problem of  esophageal  bleeding  is  characterized  by  high  incidence,  high  mortality  rate  due  to  constant  increase  of  portal hyper tension cases, recurrences, difficulties in diagnosis, anatomical and physiological features of the esophagus, low efficiency of the main methods of hemostasis. There are various surgical and conservative methods of hemostasis, which show a variety of opinions in the solution to the problem of stopping esophageal bleeding. In Mallory – Weiss syndrome, endoscopic hemostasis is considered to be the preferred method of treatment. Management of portal hypertension is the most difficult task; a wide range of operations is used from the minimally invasive operations to the liver transplantation, as well as endoscopic hemostasis (ligation, sclerotherapy). In esophageal bleeding, due to reflux esophagitis, mainly conservative treatment is suggested, operations are performed with recurrences or complications. Each kind of esophageal hemorrhage is considered as a separate problem.

The review is devoted to the generalization and analysis of domestic and foreign works describing the mechanism of development of neurogenic dysfunction of the bladder after surgery on the pelvic organs in cancer patients. All modern authors agree that the cause of these disorders is trauma of the pelvic nerves and interruption of the reflex arc. Unfortunately, when removing malignant tumors of the pelvic organs, urological complications are difficult and often impossible to avoid. This is due to the complex neuroanatomy of the bladder, its proximity to the rectum, the uterus, as well as the volume and radicality of cancer operations. The article shows that if the parasympathetic ganglia are damaged, there is a violation of the evacuation function of the bladder and a weakening or absence of the urge to urinate. If the sympathetic nervous system is damaged in isolation, on the contrary, an increase in the detrusor tone, intravesical pressure and a decrease in the capacity of the bladder is observed, which is in conditions of low bladder sphincter tone causes imperative urges, frequent urination and incontinence. Prior radiation therapy also affects the development of urological complications. Postradiated soft tissue changes, ischemia, fibrosis lead to great technical difficulties during surgery. In addition, factors that are important in the development of pelvic disorders in this category of patients include urinary system diseases and metabolic – endocrine disorders in case history.

Currently, one of the topical areas of research is the development of new antigen preparations for the specific diagnosis and prevention of brucellosis, since indication of the pathogen and prevention of the disease is complicated by the ability of brucella to dissociate, and live vaccines used for specific prevention of brucellosis have residual virulence. Thermal extracts (TE) obtained from Brucella abortus I-206 in the L- and S-form can be used as such promising antigens. It is known that TE in the L- and S-forms have immunogenic properties, as well as a modulating effect on the proliferation of immunocompetent cells, morphological changes in the immunocompetent organs of experimental animals.

The aimof the work is to study the effect of Brucella abortus thermal extracts in L- and S-forms on the functional state of the cells of experimental animals.

Materials  and  methods. The  study  was  performed  on  100  certified  white  mice.  As  objects  of  study,  we  used  the B. abortus I-206 TE in L- and S-forms. Evaluation of the effect of antigenic drugs on the functional state of phagocytes of laboratory animals in vitro was performed on peritoneal macrophages. The total activity of the respiratory chain enzymes in the NBT-test and superoxide dismutase was determined. Cells of intact animals served as controls. As a positive control, a commercial antigenic LPS preparation Escherichia coli was used. The content of cyclic nucleotides in homogenates of immunocompetent organs was determined using ELISA.

Results.This study presents materials on the study of the effect of TE on the bactericidal activity of phagocytes and the level of cyclic nucleotides in immunocompetent organs. It has been established that TEs activate oxygen-dependent bactericidal systems of phagocytes. When studying the effect of TE on the content of cyclic nucleotides in immunocompetent organs of white mice, an increase in their concentration was revealed, indicating an increase in the functional activity of the cells.Conclusion.The obtained data make it possible to substantiate the need for a further detailed study of the immunogenic properties of B. abortus TE in the L- or S-form on the organism of experimental animals.

Introduction. The current direction in medicine is the creation of immunobiological preparations to increase the effectiveness of specific immunotherapy and immunoprophylaxis, containing immunomodulators in their composition. These natural or synthetic substances can have a regulating effect on the immune system. At present, water-soluble organic-inorganic polymeric materials with nanoparticles of various chemical substances with bactericidal and immunomodulating properties can serve as such promising compounds.The aimof the work is to study the acute toxicity of polymer nanocomposites based on 1-vinil-1,2,4-triazole copolymer with N-vinylpyrrolidone with silver, gold and selenium nanoparticles and their effect on the functional state of immune system cells in vitro.

Materials and methods.The study of acute toxicity was performed on outbred white mice. The activity of superoxide dismutase and glucose-6-phosphate dehydrogenase were studied in guinea pig peritoneal macrophages. The study of spontaneous and nanocomposite-induced production of pro- (interferon gamma and tumor necrosis factor alpha) and anti-inflammatory (interleukin-4) cytokines by blood cells was carried out using clinical material obtained from volunteers using the ELISA method. Results. It has been established that nanocomposites with silver and gold nanoparticles do not cause the death of white mice, their temperature increase and body weight decrease. The average lethal dose for a nanocomposite with selenium nanoparticles was determined as 1 gram per 1 kilogram of animal mass. It was shown that the tested nanocomposites have a stimulating effect on the production of cytokines by human blood cells in vitro. It was established that a nanocomposite with selenium nanoparticles increases the activity of superoxide dismutase and glucose-6-phosphate dehydrogenase. A comparative analysis of their actions with the actions of commercial preparations of biological origin, with immunomodulatory properties.

Conclusion. The data obtained allow us to substantiate the need for further research on the effects of nanocomposites based on 1-vinyl-1,2,4-triazole copolymer with N-vinylpyrrolidone with silver, gold and selenium nanoparticles on the macroorganism in both in vitro and in vivo conditions.

Background. Statin therapy may be accompanied by a toxic effect on skeletal muscle and liver cells, the molecular mechanisms of which have not yet been fully understood.

Aim. To clarify the peculiarities of changes in the oxygen transport function of erythrocytes and antioxidant mechanisms in erythrocytes and muscles of animals with prolonged administration of statins (simvastatin).

Materials and methods. The study was conducted on outbred male rats, which during the experiment were randomly  assigned to following groups: the control group contained animals on a common ration of the vivarium, the group of comparison – animals with induced hypercholesterolemia, the main group – animals with induced hypercholesterolemia treated with simvastatin. In erythrocytes and muscle tissue of animals, indicators characterizing the state of antioxidant defense and carbohydrate metabolism were determined.

The results. The experiment showed that the administration of simvastatin to animals was characterized by aggravation of hypoxia due to hypercholesterolemia, as indicated by a sharp increase in the concentration of 2,3-BPG and lactate in erythrocytes of animals, as well as a significant decrease in the activity of G6PD. In the muscle tissue of animals, there was a decrease in the  concentration of pyruvic acid and lactate relative to the comparison group, which indicates their intensive participation in metabolic processes.

Conclusion. Based on the data obtained, it can be assumed that the peculiarity of the action of statins in erythrocytes  is the increased oxygen delivery to the tissues, which in muscles was accompanied by a decrease in the level of oxidized products. At the same time, against the background of the use of statins, despite the positive direction of adaptive reactions, signs of oxidative stress remain, which is documented by the imbalance of the SOD-catalase system and a decrease in the activity of glutathione-dependent reactions

General purulent peritonitis takes one of the first places in the structure of purulent complications. Despite the im provement of methods of diagnosis and treatment, mortality in postoperative purulent peritonitis remains quite high.

Aim of the study: develop a reproducible model of postoperative general peritonitis to study the pathophysiological mechanisms of its development and the development of pathogenetically substantiated therapy.

Materials and methods. The study was performed on 18 Wistar male rats aged 6 months, weighing 250–300 grams. Animals underwent laparotomy and modeling of postoperative general peritonitis according to the proposed method. Hospital strains of Escherichia coli BRLS 109 and Bacteroides fragilis 109 (strain ISCST1982, registered in Genbank), which we isolated from patients with acute appendicitis, with a total volume of 1.0 ml per animal, were used as infectious agents. Animals were taken out of the experiment under anesthesia with compliance with the rules of euthanasia at 1st, 3rd, 7th days after surgery. For morphological studies, samples of a fragment of the abdominal wall and cecum were taken. Bacteriological studies were performed on the 3rd, 7th day from the beginning of the experiment.

Results. It was established that all animals developed peritonitis with the progression of purulent-destructive changes in the abdominal cavity and the development of adhesions, which was confirmed by the data of the morphological method of research. According to the results of bacteriological studies on the 3rd day, exudate infection was detected in all rats (in 100 % of observations). E. coli BLS were isolated in all cases at concentrations of 103–104 CFU/ml. The strain B. fragilis is inoculated in 3 animals at a concentration of 103 CFU/ml, which made 50 %. By the 7th day, only an aerobic E. coli strain of BLS was detected in peritoneal exudate at concentrations of 103 CFU/ml in the complete absence of growth of B. fragilis.

Conclusion. We have developed a model of postoperative general peritonitis, which allows us to study the dynamics of the development of the inflammatory process in the abdominal cavity and, in terms of its clinical manifestations, is close to a real human disease. The reproducibility of the model is 100 %, which is confirmed by microbiological and morphological data.

Introduction.Healthcare-associated infections incidence is one of the most pressing issues in modern healthcare due to their high abundance as well as economic loss they cause.

The aimis to study regional features of the incidence of healthcare-associated infections.

Methods.We conducted a retrospective epidemiological analysis of nosocomial morbidity in hospitals of the Irkutsk region within 2006-2017 years. We used data, presented in the following state reports: “On the state of sanitary and epidemiological welfare of the population in the Russian Federation”, “On the state of sanitary and epidemiological welfare of the population in the Irkutsk region”.

Results and discussion.According to the results of the conducted analysis, it was shown that the average long-term prevalence of healthcare-associated infections in the Irkutsk region was 41.94 ± 2.040/00000 (Russian Federation – 17.49) with a tendency to stabilization in recent years. The therapeutic and prophylactic organizations of the surgical profile have the highest epidemiological significance (over 51 %). At the same time, the share of postoperative complications during the study period decreased by 1.5 times. We have noted a rising trend line with a positive rate of increase in the incidence of nosocomial pneumonia, which in the last two years has taken a leading position in the structure of healthcare-associated infections. The incidence of infections in newborns in the Irkutsk region ranks the third, with a specific weight of 11.54 %. Moreover, if before 2013 purulent-septic diseases of the newborns were the predominant nosological form, in recent years pneumonia has firmly taken over the leadership. During the study period we revealed an increase in the incidence of postpartum endometritis in puerperas. It has been shown that the registration of sepsis, urinary tract infections in the region is low.

The global spread of tuberculosis remains one of actual problems of public health despite of introduction of public health safety programs. Early, rapid and accurate identification of M. tuberculosis and determination of drug susceptibility are essential for treatment and management of this disease. Delay in delivering results prolongs potentially inappropriate antituberculosis therapy, contributing to emergence of drug resistance, reducing treatment options and increasing treatment duration and associated costs, resulting in increased mortality and morbidity. Faster, more comprehensive diagnostics will enable earlier use of the most appropriate drug regimen, thus improving patient outcomes and reducing overall healthcare costs. The treatment of infection based on the using of massive antimicrobial therapy with analysis of bacterial strains resistance to first line drugs (FLD) isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), ethambutol (EMB) and streptomycin (SM). However, the public health practitioners pay no attention to functional activity of human immune system genes. The interaction of bacterial genomes and immune system genes plays the major role in infection progress. There is growing evidence that, together with human and environmental factors, Mycobacterium tuberculosis complex strain diversity contributes to the variable outcome of infection and disease in human TB. We suppose that the future of diagnosis and treatment of tuberculosis lies in the field of personal medicine with comprehensive analysis of host and pathogen genes.

The lecture is devoted to the peculiarities of changes in tissue and cell perfusion of the brain with a rare pathology – venous ischemic stroke. Venous stroke, being a “relatively unknown cerebrovascular disease”, occurs up to 5 % of all cases of stroke. The terms “venous ischemia” and “venous stroke” have long been used in the literature and the definition of the venous nature of stroke should lead to a change in therapeutic tactics. Neuroimaging should ensure the verification of stroke and cerebral venous sinus thrombosis, which are the main cause of such a stroke. A certain “alertness” to the venous nature of the stroke with the expansion of the volume of radiologic methods of investigation and the performance of angiographic and perfusion CT and MR techniques, diffusion MRI allowed to increase the number of diagnosed and verified venous strokes from 0.4 % of the total number of stroke patients to 2.4 %. A distinctive feature of venous ischemic stroke from the arterial is moderate hyperemia in the central part in cases where necrosis does not develop and perifocal hyperperfusion in the development of necrosis. Moderate plethora, defined by perfusion parameters (up to 30 % CBF, CBV, MTT) of CT, MRI and SPECT techniques, and not oligemia is the primary damaging factor of the pathogenesis of venous stroke in contrast to the arterial and hyperemia patterns should be the reference points in emergency diagnosis venous stroke along with tomoangiographic symptoms of cerebral venous sinustrombosis.